Sustained release dosage forms for a jak1 inhibitor

ABSTRACT

This invention relates to sustained release dosage forms comprising {1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile, or a pharmaceutically acceptable salt thereof, and doses and methods related thereto.

This application is a continuation of U.S. patent application Ser. No.15/599,084, filed May 18, 2017, which claims the benefit of priority ofU.S. patent application Ser. No. 14/453,129, filed Aug. 6, 2014, whichclaims the benefit of priority of U.S. Prov. Appl. No. 61/863,325, filedAug. 7, 2013, and U.S. Prov. Appl. No. 61/913,066, filed Dec. 6, 2013,each of which is incorporated herein by reference in its entirety.

TECHNICAL FIELD

This application relates to a sustained release dosage form comprising{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, and doses and methodsrelated thereto.

BACKGROUND

Protein kinases (PKs) regulate diverse biological processes includingcell growth, survival, differentiation, organ formation, morphogenesis,neovascularization, tissue repair, and regeneration, among others.Protein kinases also play specialized roles in a host of human diseasesincluding cancer. Cytokines, low-molecular weight polypeptides orglycoproteins, regulate many pathways involved in the host inflammatoryresponse to sepsis. Cytokines influence cell differentiation,proliferation and activation, and can modulate both pro-inflammatory andanti-inflammatory responses to allow the host to react appropriately topathogens. Signaling of a wide range of cytokines involves the Januskinase family (JAKs) of protein tyrosine kinases and Signal Transducersand Activators of Transcription (STATs). There are four known mammalianJAKs: JAK1 (Janus kinase-1), JAK2, JAK3 (also known as Janus kinase,leukocyte; JAKL; and L-JAK), and TYK2 (protein-tyrosine kinase 2).

Cytokine-stimulated immune and inflammatory responses contribute topathogenesis of diseases: pathologies such as severe combinedimmunodeficiency (SCID) arise from suppression of the immune system,while a hyperactive or inappropriate immune/inflammatory responsecontributes to the pathology of autoimmune diseases (e.g., asthma,systemic lupus erythematosus, thyroiditis, myocarditis), and illnessessuch as scleroderma and osteoarthritis (Ortmann, R. A., T. Cheng, et al.(2000) Arthritis Res 2(1): 16-32).

Deficiencies in expression of JAKs are associated with many diseasestates. For example, Jak1−/− mice are runted at birth, fail to nurse,and die perinatally (Rodig, S. J., M. A. Meraz, et al. (1998) Cell93(3): 373-83). Jak2−/− mouse embryos are anemic and die around day 12.5postcoitum due to the absence of definitive erythropoiesis.

The JAK/STAT pathway, and in particular all four JAKs, are believed toplay a role in the pathogenesis of asthmatic response, chronicobstructive pulmonary disease, bronchitis, and other relatedinflammatory diseases of the lower respiratory tract. Multiple cytokinesthat signal through JAKs have been linked to inflammatorydiseases/conditions of the upper respiratory tract, such as thoseaffecting the nose and sinuses (e.g., rhinitis and sinusitis) whetherclassically allergic reactions or not. The JAK/STAT pathway has alsobeen implicated in inflammatory diseases/conditions of the eye andchronic allergic responses.

Activation of JAK/STAT in cancers may occur by cytokine stimulation(e.g. IL-6 or GM-CSF) or by a reduction in the endogenous suppressors ofJAK signaling such as SOCS (suppressor or cytokine signaling) or PIAS(protein inhibitor of activated STAT) (Boudny, V., and Kovarik, J.,Neoplasm. 49:349-355, 2002). Activation of STAT signaling, as well asother pathways downstream of JAKs (e.g., Akt), has been correlated withpoor prognosis in many cancer types (Bowman, T., et al. Oncogene19:2474-2488, 2000). Elevated levels of circulating cytokines thatsignal through JAK/STAT play a causal role in cachexia and/or chronicfatigue. As such, JAK inhibition may be beneficial to cancer patientsfor reasons that extend beyond potential anti-tumor activity.

JAK2 tyrosine kinase can be beneficial for patients withmyeloproliferative disorders, e.g., polycythemia vera (PV), essentialthrombocythemia (ET), myeloid metaplasia with myelofibrosis (MMM)(Levin, et al., Cancer Cell, vol. 7, 2005: 387-397). Inhibition of theJAK2V617F kinase decreases proliferation of hematopoietic cells,suggesting JAK2 as a potential target for pharmacologic inhibition inpatients with PV, ET, and MMM.

Inhibition of the JAKs may benefit patients suffering from skin immunedisorders such as psoriasis, and skin sensitization. The maintenance ofpsoriasis is believed to depend on a number of inflammatory cytokines inaddition to various chemokines and growth factors (JCI, 113:1664-1675),many of which signal through JAKs (Adv Pharmacol. 2000; 47:113-74).

Due to the usefulness of compounds which inhibit JAK in targetingaugmentation or suppression of the immune and inflammatory pathways(such as immunosuppressive agents for organ transplants), as well as thetreatment of autoimmune diseases, diseases involving a hyperactiveinflammatory response (e.g., eczema), allergies, cancer (e.g., prostate,leukemia, multiple myeloma), and some immune reactions (e.g., skin rashor contact dermatitis or diarrhea) caused by other therapeutics, thereis a need for improved formulations for administering JAK kinases. Thedosages forms described herein, as well as the doses and methodsdescribed supra are directed toward this need and other ends.

SUMMARY

JAK inhibitors are described in U.S. Ser. No. 13/043,986 (US2011/0224190), filed Mar. 9, 2011, which is incorporated herein byreference in its entirety, including{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,which is depicted below as Formula I.

The present application provides, inter alia, sustained-release dosageforms comprising about 25 mg to about 600 mg (e.g., 25 mg, 100 mg, 200mg, 300 mg, or 600 mg) on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof.

The present invention further provides one or more sustained releasedosage forms each comprising{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof; wherein said one or moresustained release dosage forms together provide a once-daily oral dosageof about 400 mg to about 600 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl)}acetonitrile,or a pharmaceutically acceptable salt thereof, to a patient.

The present invention also provides a dose, comprising one or moresustained release dosage forms each comprising{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, wherein said doseprovides a once-daily oral dosage of about 400 mg to about 600 mg on afree base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, to a patient.

The present application further provides one or more sustained releasedosage forms as described herein, which together provide a once-dailyoral dosage of about 600 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, to a patient.

The present application also provides a dose comprising one or moresustained release dosage forms as described herein, which togetherprovide a once-daily oral dosage of about 600 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, to a patient.

The present application further provides methods of treating anautoimmune disease, a cancer, a myeloproliferative disorder, aninflammatory disease, a bone resorption disease, or organ transplantrejection in a patient in need thereof, comprising orally administeringto said patient one or more sustained release dosage forms as describedherein.

The present application also provides methods of treating an autoimmunedisease, a cancer, a myeloproliferative disorder, an inflammatorydisease, a bone resorption disease, or organ transplant rejection in apatient in need thereof, comprising orally administering to said patienta once-daily dose of about 400 mg to about 600 mg on a free base basisof{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, wherein the dosecomprises one or more sustained release dosage forms each comprising{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof.

The present application further provides methods of treating anautoimmune disease, a cancer, a myeloproliferative disorder, aninflammatory disease, a bone resorption disease, or organ transplantrejection in a patient in need thereof, comprising orally administeringto said patient one or more sustained release dosage as describedherein.

The present application also provides methods of treating an autoimmunedisease, a cancer, a myeloproliferative disorder, an inflammatorydisease, a bone resorption disease, or organ transplant rejection in apatient in need thereof, wherein the method comprises orallyadministering to said patient the one or more sustained release dosageforms as a once-daily dosage of about 600 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof.

DESCRIPTION OF DRAWINGS

FIG. 1A-C depicts plasma concentrations for the compound of Formula I(Mean±SE) in healthy subjects receiving single doses of 300 mg IRcapsules (1A: Cohorts 1-4, fasted), SR1, SR2, SR3, and SR4 tablets (2B:Cohorts 1-4, fasted; and 2C: Cohorts 1-4, fed a high-fat meal).

FIG. 2A-B depicts single-dose 300 mg SR3 PK profiles (Mean±SE) (2A:Cohort 3, SR3, fasted versus high-fat meal; and 2B: Cohort 5, SR3,fasted versus medium-fat meal).

FIG. 3 depicts a comparison of PK profiles (mean±SE) between the 25 mgand 100 mg SR3 tablets (treatment A vs C) and the food effect of ahigh-fat meal on the 25 mg SR3 tablet (treatment B vs A).

FIG. 4A-B depicts the percent change from baseline for hemoglobin forseveral dosing regimens for sustained release tablets versus placebo(FIG. 4A as a function of days; FIG. 4B as a function of total averageconcentration (Cavg)).

FIG. 5A depicts the percentage of patients having a ≥50% reduction intotal symptom score (TSS) at week 12 by dose cohort (100 mg BID, 200 mgBID, and 600 mg QD).

FIG. 5B depicts the percent change in total symptom score (TSS) frombaseline at week 12 by dose cohort (100 mg BID, 200 mg BID, and 600 mgQD).

FIG. 6A depicts mean hemoglobin levels over time by dose cohort (100 mgBID, 200 mg BID, and 600 mg QD).

FIG. 6B depicts mean hemoglobin levels (g/dL) over time by dose cohort(100 mg BID, 200 mg BID, and 600 mg QD) at 48 weeks.

FIG. 6C depicts mean hemoglobin levels (g/dL) over time by dose cohortat 48 weeks as an average for three dose cohorts as compared toindividuals dosed with placebo or ruxolitinib.

DETAILED DESCRIPTION

The present application provides sustained-release dosage formscomprising{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof. In some embodiments, thepresent application provides a sustained-release dosage form comprisingabout 25 mg to about 600 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof.

In some embodiments, the sustained-release dosage form comprises about300 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof.

In some embodiments, the sustained-release dosage form comprises about200 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof.

In some embodiments, the sustained-release dosage form comprises about100 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof.

In some embodiments, the sustained-release dosage form comprises about300 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileadipic acid salt.

In some embodiments, the sustained-release dosage form comprises about200 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileadipic acid salt.

In some embodiments, the sustained-release dosage form comprises about100 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileadipic acid salt.

In some embodiments of the sustained-release dosage form comprisingabout 100 mg, oral administration of three of said dosage forms to afasted individual provides a mean peak plasma concentration (C_(max)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 100 nM to about 1000 nM. As used in this context, oraladministration means that a single dose is administered to theindividual (in this case, 3×100 mg) and the PK parameter is calculatedfrom the measurements of plasma concentration over time. In thiscontext, the PK parameter (in this case, C_(max)) is being used tocharacterize the single sustained release dosage form (i.e., the claimsare directed to a single dosage form, not three dosage forms).

In some embodiments of the sustained-release dosage form comprisingabout 100 mg, oral administration of three of said dosage forms to afasted individual provides a mean peak plasma concentration (C_(max)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 400 nM to about 700 nM.

In some embodiments of the sustained-release dosage form comprisingabout 100 mg, oral administration of three of said dosage forms to afasted individual provides a mean time to peak plasma concentration(T_(max)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 0.5 hours to about 3 hours.

In some embodiments of the sustained-release dosage form comprisingabout 100 mg, oral administration of three of said dosage forms to afasted individual provides a mean time to peak plasma concentration(T_(max)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof at least 0.5 hours.

In some embodiments of the sustained-release dosage form comprisingabout 100 mg, oral administration of three of said dosage forms to afasted individual provides a ratio of mean peak plasma concentration(C_(max)) to mean 12-hour plasma concentration (C_(12h)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 5 to about 50.

In some embodiments of the sustained-release dosage form comprisingabout 100 mg, oral administration of three of said dosage forms to afasted individual provides a ratio of mean peak plasma concentration(C_(max)) to mean 12-hour plasma concentration (C_(12h)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 9 to about 40.

In some embodiments of the sustained-release dosage form comprisingabout 100 mg, oral administration of three of said dosage forms to afasted individual provides a ratio of mean peak plasma concentration(C_(max)) to mean 12-hour plasma concentration (C_(12h)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 15 to about 30.

In some embodiments of the sustained-release dosage form comprisingabout 100 mg, oral administration of three of said dosage forms to afasted individual provides a mean half-life (t_(1/2)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 5 hours to about 15 hours.

In some embodiments of the sustained-release dosage form comprisingabout 100 mg, oral administration of three of said dosage forms to afasted individual provides a mean half-life (t_(1/2)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 7 hours to about 12 hours.

In some embodiments of the sustained-release dosage form comprisingabout 100 mg, oral administration of three of said dosage forms to afasted individual provides a mean half-life (t_(1/2)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 1 hour to about 20 hours.

In some embodiments of the sustained-release dosage form comprisingabout 100 mg, oral administration of three of said dosage forms to afasted individual provides a mean bioavailability (AUC_(0-∞)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 1000 nM*h to about 4000 nM*h.

In some embodiments of the sustained-release dosage form comprisingabout 100 mg, oral administration of three of said dosage forms to afasted individual provides a mean bioavailability (AUC_(0-∞)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 1500 nM*h to about 3100 nM*h.

In some embodiments of the sustained-release dosage form comprisingabout 100 mg, oral administration of three of said dosage forms to anindividual after a high-fat meal provides a mean peak plasmaconcentration (C_(max)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 200 nM to about 2000 nM.

In some embodiments of the sustained-release dosage form comprisingabout 100 mg, oral administration of three of said dosage forms to anindividual after a high-fat meal provides a mean peak plasmaconcentration (C_(max)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 500 nM to about 1500 nM.

In some embodiments of the sustained-release dosage form comprisingabout 100 mg, oral administration of three of said dosage forms to anindividual after a high-fat meal provides a mean time to peak plasmaconcentration (T_(max)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 1 hour to about 9 hours.

In some embodiments of the sustained-release dosage form comprisingabout 100 mg, oral administration of three of said dosage forms to anindividual after a high-fat meal provides a mean time to peak plasmaconcentration (T_(max)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof at least 1.5 hours.

In some embodiments of the sustained-release dosage form comprisingabout 100 mg, oral administration of three of said dosage forms to anindividual after a high-fat meal provides a ratio of mean peak plasmaconcentration (C_(max)) to mean 12-hour plasma concentration (C_(12h))of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 10 to about 70.

In some embodiments of the sustained-release dosage form comprisingabout 100 mg, oral administration of three of said dosage forms to anindividual after a high-fat meal provides a ratio of mean peak plasmaconcentration (C_(max)) to mean 12-hour plasma concentration (C_(12h))of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 15 to about 50.

In some embodiments of the sustained-release dosage form comprisingabout 100 mg, oral administration of three of said dosage forms to anindividual after a high-fat meal provides a ratio of mean peak plasmaconcentration (C_(max)) to mean 12-hour plasma concentration (C_(12h))of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 25 to about 45.

In some embodiments of the sustained-release dosage form comprisingabout 100 mg, oral administration of three of said dosage forms to anindividual after a high-fat meal provides a mean half-life (t_(1/2)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 1 hour to about 7 hours.

In some embodiments of the sustained-release dosage form comprisingabout 100 mg, oral administration of three of said dosage forms to anindividual after a high-fat meal provides a mean half-life (t_(1/2)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 2 hours to about 5 hours.

In some embodiments of the sustained-release dosage form comprisingabout 100 mg, oral administration of three of said dosage forms to anindividual after a high-fat meal provides a mean bioavailability(AUC_(0-∞)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 2000 nM*h to about 5000 nM*h.

In some embodiments of the sustained-release dosage form comprisingabout 100 mg, oral administration of three of said dosage forms to anindividual after a high-fat meal provides a mean bioavailability(AUC_(0-∞)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 3000 nM*h to about 4000 nM*h.

In some embodiments, the percent geometric mean ratio of the sustainedrelease dosage form relative to an immediate release dosage form forC_(max) is about 15% to about 30%, wherein one or more immediate releasedosage forms and one or more sustained release dosage forms areindependently orally administered to fasted individuals as a singledose, wherein the same size dose of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt, is administered.

In some embodiments, the percent geometric mean ratio of the sustainedrelease dosage form relative to an immediate release dosage form forC_(max) is about 15% to about 30%, wherein one or more immediate releasedosage forms and one or more sustained release dosage forms areindependently orally administered to fasted individuals as a singledose, wherein the same size dose of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt, is administered.

In some embodiments, the percent geometric mean ratio of the sustainedrelease dosage form relative to an immediate release dosage form forAUC_(0-∞) is about 40% to about 55%, wherein one or more immediaterelease dosage forms and one or more sustained release dosage forms areindependently orally administered to fasted individuals as a singledose, wherein the same size dose of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt, is administered.

In some embodiments, the percent geometric mean ratio for C_(max) of thesustained release dosage form orally administered to an individual aftera high-fat meal relative to the sustained release dosage form orallyadministered to a fasted individual is about 150% to about 250%.

In some embodiments, the percent geometric mean ratio for AUC_(0-∞) ofthe sustained release dosage form orally administered to an individualafter a high-fat meal relative to the sustained release dosage formorally administered to a fasted individual is about 125% to about 170%.

In some embodiments, the sustained-release dosage forms of the inventionmay include a sustained-release matrix former. Example sustained-releasematrix formers include cellulosic ethers such as hydroxypropylmethylcellulose (HPMC, hypromellose) which is a high viscosity polymer,and methyl celluloses. Example hydroxypropyl methylcelluloses includeMethocel™ K15M, Methocel™ K4M, Methocel™ K100LV, Methocel™ E3, Methocel™E5, Methocel™ E6, Methocel™ E15, Methocel™ E50, Methocel™ E10M,Methocel™ E4M, and Methocel™ E10M. In some embodiments, the sustainedrelease dosage form comprises one or more hypromelloses. In someembodiments, the sustained release dosage form comprises a firsthypromellose characterized by having an apparent viscosity at aconcentration of 2% in water of about 80 cP to about 120 cP and a secondhypromellose characterized by having an apparent viscosity at aconcentration of 2% in water of about 3000 cP to about 5600 cP. In someembodiments, the sustained release dosage form comprises about 8% toabout 20% by weight of one or more hypromelloses. In some embodiments,the sustained release dosage form comprises about 10% to about 15% byweight of one or more hypromelloses.

In some embodiments, the sustained-release dosage forms of the inventioncan further include one or more fillers, glidants, disintegrants,binders, or lubricants as inactive ingredients. In some embodiments, thefiller comprises microcrystalline cellulose, lactose monohydrate, orboth. In some embodiments, the sustained release dosage form comprisesabout 16% to about 22% by weight of microcrystalline cellulose. In someembodiments, the sustained release dosage form comprises about 45% toabout 55% by weight of lactose monohydrate.

In some embodiments, lubricants can be present in the dosage forms ofthe invention in an amount of 0 to about 5% by weight. Non-limitingexamples of lubricants include magnesium stearate, stearic acid(stearin), hydrogenated oil, polyethylene glycol, sodium stearylfumarate, and glyceryl behenate. In some embodiments, the formulationsinclude magnesium stearate, stearic acid, or both. In some embodiments,the sustained release dosage form comprises about 0.3% to about 0.7% byweight of magnesium stearate.

In some embodiments, glidants may be present in the dosage forms. Insome embodiments, glidants can be present in the dosage forms of theinvention in an amount of 0 to about 5% by weight. Non-limiting examplesof glidants include talc, colloidal silicon dioxide, and cornstarch. Insome embodiments, the glidant is colloidal silicon dioxide.

In some embodiments, film-coating agents can be present in an amount of0 to about 5% by weight. Non-limiting illustrative examples offilm-coating agents include hypromellose or polyvinyl alcohol basedcoating with titanium dioxide, talc and optionally colorants availablein several commercially available complete coating systems.

In some embodiments, the sustained release dosage form comprisespregelatinized starch.

In some embodiments, the sustained release dosage form is a tablet.

In some embodiments, the sustained release dosage form is prepared byprocess comprising wet granulation.

In some embodiments, the sustained release dosage form comprises one ormore excipients independently selected from hypromelloses andmicrocrystalline celluloses.

In some embodiments, the sustained release dosage form comprises one ormore excipients independently selected from hypromelloses,microcrystalline celluloses, magnesium stearate, lactose, and lactosemonohydrate.

In some embodiments, the sustained release dosage form comprises one ormore excipients independently selected from hypromelloses,microcrystalline celluloses, magnesium stearate, lactose, lactosemonohydrate, and pregelatinized starch.

The present invention further provides one or more sustained releasedosage forms each comprising{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof; wherein said one or moresustained release dosage forms together provide a once-daily oral dosageof about 400 mg to about 600 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, to a patient.

The present invention also provides a dose, comprising one or moresustained release dosage forms each comprising{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof; wherein said doseprovides a once-daily oral dosage of about 400 mg to about 600 mg on afree base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, to a patient.

The present application further provides one or more sustained releasedosage forms as described herein, which together provide a once-dailyoral dosage of about 600 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, to a patient.

The present application further provides one or more sustained releasedosage forms as described herein, which together provide a once-dailyoral dosage of about 500 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, to a patient.

The present application further provides one or more sustained releasedosage forms as described herein, which together provide a once-dailyoral dosage of about 400 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, to a patient.

In some embodiments, the one or more sustained release dosage forms aresix dosage forms of about 100 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, are provided. In someembodiments, the one or more sustained release dosage forms are threedosage forms of about 200 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, are provided. In someembodiments, the one or more sustained release dosage forms are twodosage forms of about 300 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, are provided. In someembodiments, the one or more sustained release dosage forms is onedosage form of about 600 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, is provided.

The present application also provides a dose comprising one or moresustained release dosage forms as described herein, which provide aonce-daily oral dosage of about 600 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, to a patient.

The present application also provides a dose comprising one or moresustained release dosage forms as described herein, which provide aonce-daily oral dosage of about 500 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, to a patient.

The present application also provides a dose comprising one or moresustained release dosage forms as described herein, which provide aonce-daily oral dosage of about 400 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, to a patient.

In some embodiments, the dose comprises six dosage forms of about 100 mgon a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof. In some embodiments, thedose comprises three dosage forms of about 200 mg on a free base basisof{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof. In some embodiments, thedose comprises two dosage forms of about 300 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof. In some embodiments, thedose comprises one dosage form of about 600 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof.

The present application further provides a kit comprising one or moresustained release dosage forms as described herein, which togetherprovide a once-daily oral dosage of about 400 mg to about 600 mg on afree base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, to a patient. In someembodiments, the kit further comprises an instruction to administer theone or more sustained release dosage forms as a once-daily dose of about400 mg to about 600 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof.

The present application further provides a kit comprising one or moresustained release dosage forms as described herein, which togetherprovide a once-daily oral dosage of about 600 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, to a patient. In someembodiments, the kit further comprises an instruction to administer theone or more sustained release dosage forms as a once-daily dose of about600 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof.

The present application further provides a kit comprising one or moresustained release dosage forms as described herein, which togetherprovide a once-daily oral dosage of about 500 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, to a patient. In someembodiments, the kit further comprises an instruction to administer theone or more sustained release dosage forms as a once-daily dose of about600 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof.

The present application further provides a kit comprising one or moresustained release dosage forms as described herein, which togetherprovide a once-daily oral dosage of about 400 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, to a patient. In someembodiments, the kit further comprises an instruction to administer theone or more sustained release dosage forms as a once-daily dose of about600 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof.

In some embodiments, the kit comprises six dosage forms of about 100 mgon a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof. In some embodiments, thekit comprises three dosage forms of about 200 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof. In some embodiments, thekit comprises two dosage forms of about 300 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof. In some embodiments, thekit comprises one dosage form of about 600 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof.

As used herein, “sustained-release” is used as generally understood inthe art and refers to a formulation designed to slowly release theactive ingredient into a patient after oral administration.

As used herein, “dose” refers to the total amount of the compound ofFormula I orally administered to the individual or patient. The dose maybe in a single dosage form, or a plurality of dosage forms (e.g., a 600mg dose may be one 600 mg dosage form, two 300 mg dosage forms, three200 mg dosage forms, six 100 mg dosage forms, etc.). Hence, a dose canrefer to a plurality of pills to be taken by a patient at nearlysimultaneously.

As used herein, “a fasted individual” means an individual who has fastedfor at least 10 hours prior to administration of the dose.

As used herein, “mean” when preceding a pharmacokinetic value (e.g. meanC_(max)) represents the arithmetic mean value of the pharmacokineticvalue taken from a population of patients unless otherwise specified.

As used herein, “C_(max)” means the maximum observed plasmaconcentration.

As used herein, “C_(12h)” refers to the plasma concentration measured at12 hours from administration.

As used herein, “T_(max)” refers to the time at which the maximum bloodplasma concentration is observed.

As used herein, “T_(1/2)” refers to the time at which the plasmaconcentration is half of the observed maximum.

As used herein, “AUC” refers to the area under the plasmaconcentration-time curve which is a measure of total bioavailability.

As used herein, “AUC_(0-∞)” refers to the area under the plasmaconcentration-time curve extrapolated to infinity.

As used herein, “AUC_(0-t)” refers to the area under the plasmaconcentration-time curve from time 0 to the last time point with aquantifiable plasma concentration, usually about 12-36 hours.

As used herein, “AUC_(0-τ)” refers to the area under the plasmaconcentration-time curve from time 0 to the time of the next dose.

As used herein, “Cl/F” refers to oral clearance.

The present invention also includes pharmaceutically acceptable salts ofthe compounds described herein. As used herein, “pharmaceuticallyacceptable salts” refers to derivatives of the disclosed compoundswherein the parent compound is modified by converting an existing acidor base moiety to its salt form. Examples of pharmaceutically acceptablesalts include, but are not limited to, mineral or organic acid salts ofbasic residues such as amines; alkali or organic salts of acidicresidues such as carboxylic acids; and the like. The pharmaceuticallyacceptable salts of the present invention include the non-toxic salts ofthe parent compound formed, for example, from non-toxic inorganic ororganic acids. The pharmaceutically acceptable salts of the presentinvention can be synthesized from the parent compound which contains abasic or acidic moiety by conventional chemical methods. Generally, suchsalts can be prepared by reacting the free acid or base forms of thesecompounds with a stoichiometric amount of the appropriate base or acidin water or in an organic solvent, or in a mixture of the two;generally, non-aqueous media like ether, ethyl acetate, alcohols (e.g.,methanol, ethanol, iso-propanol, or butanol) or acetonitrile (ACN) arepreferred. Lists of suitable salts are found in Remington'sPharmaceutical Sciences, 17th ed., Mack Publishing Company, Easton, Pa.,1985, p. 1418 and Journal of Pharmaceutical Science, 66, 2 (1977), eachof which is incorporated herein by reference in its entirety. In someembodiments, the compounds described herein include the N-oxide forms.

Methods

The present application further provides methods of treating anautoimmune disease, a cancer, a myeloproliferative disorder, aninflammatory disease, a bone resorption disease, or organ transplantrejection in a patient in need thereof, comprising orally administeringto said patient one or more sustained release dosage forms as describedherein.

The present application also provides a method of treating an autoimmunedisease, a cancer, a myeloproliferative disorder, an inflammatorydisease, a bone resorption disease, or organ transplant rejection in apatient in need thereof, comprising orally administering to said patienta once-daily dose of about 400 mg to about 600 mg on a free base basisof{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, wherein the dosecomprises one or more sustained release dosage forms each comprising{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof.

The present application further provides a method of treating anautoimmune disease, a cancer, a myeloproliferative disorder, aninflammatory disease, a bone resorption disease, or organ transplantrejection in a patient in need thereof, comprising orally administeringto said patient one or more sustained release dosage as describedherein.

The present application also provides a method of treating an autoimmunedisease, a cancer, a myeloproliferative disorder, an inflammatorydisease, a bone resorption disease, or organ transplant rejection in apatient in need thereof, wherein the method comprises orallyadministering to said patient the one or more sustained release dosageforms as a once-daily dosage of about 600 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof.

The present application also provides a method of treating an autoimmunedisease, a cancer, a myeloproliferative disorder, an inflammatorydisease, a bone resorption disease, or organ transplant rejection in apatient in need thereof, wherein the method comprises orallyadministering to said patient the one or more sustained release dosageforms as a once-daily dosage of about 500 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof.

The present application also provides a method of treating an autoimmunedisease, a cancer, a myeloproliferative disorder, an inflammatorydisease, a bone resorption disease, or organ transplant rejection in apatient in need thereof, wherein the method comprises orallyadministering to said patient the one or more sustained release dosageforms as a once-daily dosage of about 400 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof.

In some embodiments of the methods in the preceding three paragraphs,the one or more sustained release dosage forms are six dosage forms ofabout 100 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, are provided. In someembodiments of the methods in the preceding three paragraphs, the one ormore sustained release dosage forms are three dosage forms of about 200mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, are provided. In someembodiments of the methods in the preceding three paragraphs, the one ormore sustained release dosage forms are two dosage forms of about 300 mgon a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, are provided. In someembodiments of the methods in the preceding three paragraphs, the one ormore sustained release dosage forms is one dosage form of about 600 mgon a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, is provided.

In some embodiments, oral administration of one or more sustainedrelease dosage forms to a fasted individual provides a mean time to peakplasma concentration (T_(max)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 0.5 hours to about 3 hours.

In some embodiments, oral administration of one or more sustainedrelease dosage forms to a fasted individual provides a mean time to peakplasma concentration (T_(max)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof at least 0.5 hours.

In some embodiments, oral administration of one or more sustainedrelease dosage forms to a fasted individual provides a ratio of meanpeak plasma concentration (C_(max)) to mean 12-hour plasma concentration(C_(12h)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 5 to about 50.

In some embodiments, oral administration of one or more sustainedrelease dosage forms to a fasted individual provides a ratio of meanpeak plasma concentration (C_(max)) to mean 12-hour plasma concentration(C_(12h)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 9 to about 40.

In some embodiments, oral administration of one or more sustainedrelease dosage forms to a fasted individual provides a ratio of meanpeak plasma concentration (C_(max)) to mean 12-hour plasma concentration(C_(12h)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 15 to about 30.

In some embodiments, oral administration of one or more sustainedrelease dosage forms to a fasted individual provides a mean half-life(t_(1/2)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 1 hour to about 20 hours.

In some embodiments, oral administration of one or more sustainedrelease dosage forms to an individual after a high-fat meal provides amean time to peak plasma concentration (T_(max)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 1 hour to about 9 hours.

In some embodiments, oral administration of one or more sustainedrelease dosage forms to an individual after a high-fat meal provides amean time to peak plasma concentration (T_(max)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof at least 1.5 hours.

In some embodiments, oral administration of one or more sustainedrelease dosage forms to an individual after a high-fat meal provides aratio of mean peak plasma concentration (C_(max)) to mean 12-hour plasmaconcentration (C_(12h)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 10 to about 70.

In some embodiments, oral administration of one or more sustainedrelease dosage forms to an individual after a high-fat meal provides aratio of mean peak plasma concentration (C_(max)) to mean 12-hour plasmaconcentration (C_(12h)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 15 to about 50.

In some embodiments, oral administration of one or more sustainedrelease dosage forms to an individual after a high-fat meal provides aratio of mean peak plasma concentration (C_(max)) to mean 12-hour plasmaconcentration (C_(12h)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 25 to about 45.

In some embodiments, oral administration of one or more sustainedrelease dosage forms to an individual after a high-fat meal provides amean half-life (t_(1/2)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 1 hour to about 7 hours.

In some embodiments, oral administration of one or more sustainedrelease dosage forms to an individual after a high-fat meal provides amean half-life (t_(1/2)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof about 2 hours to about 5 hours.

In some embodiments, the one or more sustained release dosage forms areeach a tablet. In some embodiments, the one or more sustained releasedosage forms are prepared by process comprising wet granulation.

In some embodiments, the one or more sustained release dosage forms eachcomprises one or more hypromelloses. In some embodiments, the one ormore sustained release dosage forms each comprises one or moreexcipients independently selected from hypromelloses andmicrocrystalline celluloses. In some embodiments, the one or moresustained release dosage forms each comprises one or more excipientsindependently selected from hypromelloses, microcrystalline celluloses,magnesium stearate, lactose, and lactose monohydrate. In someembodiments, the one or more sustained release dosage forms eachcomprises a first hypromellose characterized by having an apparentviscosity at a concentration of 2% in water of about 80 cP to about 120cP and a second hypromellose characterized by having an apparentviscosity at a concentration of 2% in water of about 3000 cP to about5600 cP.

In some embodiments, the one or more sustained release dosage forms eachcomprises about 10% to about 15% by weight of one or more hypromelloses.In some embodiments, the one or more sustained release dosage forms eachcomprises about 16% to about 22% by weight of microcrystallinecellulose. In some embodiments, the one or more sustained release dosageforms each comprises about 45% to about 55% by weight of lactosemonohydrate. In some embodiments, the one or more sustained releasedosage forms each comprises about 0.3% to about 0.7% by weight ofmagnesium stearate.

In some embodiments, the present application provides a method oftreating myelofibrosis in a patient, comprising orally administering tosaid patient a once-daily dose of about 400 mg to about 600 mg on a freebase basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, wherein the dosecomprises one or more sustained release dosage forms each comprising{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof; wherein the methodresults in a reduced total symptom score (TSS) of said patient comparedwith baseline. In some embodiments, the present application provides amethod of treating myelofibrosis in a patient, comprising orallyadministering to said patient the one or more sustained release dosageforms as a once-daily dosage of about 600 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, wherein the methodresults in a reduced total symptom score (TSS) of said patient comparedwith baseline.

In some embodiments, the present application provides a method oftreating myelofibrosis in a patient, comprising orally administering tosaid patient the one or more sustained release dosage forms as aonce-daily dosage of about 500 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof; wherein the methodresults in a reduced total symptom score (TSS) of said patient comparedwith baseline.

In some embodiments, the present application provides a method oftreating myelofibrosis in a patient, comprising orally administering tosaid patient the one or more sustained release dosage forms as aonce-daily dosage of about 400 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof; wherein the methodresults in a reduced total symptom score (TSS) of said patient comparedwith baseline.

In some embodiments of the methods in the preceding three paragraphs,the one or more sustained release dosage forms are six dosage forms ofabout 100 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, are provided. In someembodiments of the methods in the preceding three paragraphs, the one ormore sustained release dosage forms are three dosage forms of about 200mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, are provided. In someembodiments of the methods in the preceding three paragraphs, the one ormore sustained release dosage forms are two dosage forms of about 300 mgon a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, are provided. In someembodiments of the methods in the preceding three paragraphs, the one ormore sustained release dosage forms is one dosage form of about 600 mgon a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, is provided.

In some embodiments, “total symptom score (TSS)” refers to the TSSderived from the modified Myelofibrosis Symptom Assessment Form (MFSAF)(e.g., v3.0) electronic diary as compared with baseline (baseline is thepatient's baseline TSS before treatment). In some embodiments,myelofibrosis is primary myelofibrosis (PMF), post-polycythemia vera MF,or post-essential thrombocythemia MF.

The present application also provides a method of treating an autoimmunedisease, a cancer, a myeloproliferative disorder, an inflammatorydisease, a bone resorption disease, or organ transplant rejection in apatient in need thereof, comprising orally administering to said patienta once-daily dose of about 400 mg to about 600 mg on a free base basisof{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, wherein the dosecomprises one or more sustained release dosage forms each comprising{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof; wherein said methodresults in reduced anemia.

The present application also provides a method of treating an autoimmunedisease, a cancer, a myeloproliferative disorder, an inflammatorydisease, a bone resorption disease, or organ transplant rejection in apatient in need thereof, wherein the method comprises orallyadministering to said patient the one or more sustained release dosageforms as a once-daily dosage of about 600 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof; wherein said methodresults in reduced anemia.

The present application also provides a method of treating an autoimmunedisease, a cancer, a myeloproliferative disorder, an inflammatorydisease, a bone resorption disease, or organ transplant rejection in apatient in need thereof, wherein the method comprises orallyadministering to said patient the one or more sustained release dosageforms as a once-daily dosage of about 500 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof; wherein said methodresults in reduced anemia.

The present application also provides a method of treating an autoimmunedisease, a cancer, a myeloproliferative disorder, an inflammatorydisease, a bone resorption disease, or organ transplant rejection in apatient in need thereof, wherein the method comprises orallyadministering to said patient the one or more sustained release dosageforms as a once-daily dosage of about 400 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof; wherein said methodresults in reduced anemia. In some embodiments, the one or moresustained release dosage forms are six dosage forms of about 100 mg on afree base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, are provided. In someembodiments, the one or more sustained release dosage forms are threedosage forms of about 200 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, are provided. In someembodiments, the one or more sustained release dosage forms are twodosage forms of about 300 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, are provided. In someembodiments, the one or more sustained release dosage forms is onedosage form of about 600 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, is provided.

Reduced anemia is relative to that experienced for a twice-daily dose of200 mg on a free base basis of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof, wherein the dosecomprises one or more sustained release dosage forms each comprising{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof.

The compound of Formula I is a JAK inhibitor. A JAK1 selective inhibitoris a compound that inhibits JAK1 activity preferentially over otherJanus kinases. JAK1 plays a central role in a number of cytokine andgrowth factor signaling pathways that, when dysregulated, can result inor contribute to disease states. For example, IL-6 levels are elevatedin rheumatoid arthritis, a disease in which it has been suggested tohave detrimental effects (Fonesca, J. E. et al., Autoimmunity Reviews,8:538-42, 2009). Because IL-6 signals, at least in part, through JAK1,antagonizing IL-6 directly or indirectly through JAK1 inhibition isexpected to provide clinical benefit (Guschin, D., N., et al Embo J14:1421, 1995; Smolen, J. S., et al. Lancet 371:987, 2008). Moreover, insome cancers JAK1 is mutated resulting in constitutive undesirable tumorcell growth and survival (Mullighan C G, Proc Natl Acad Sci USA.106:9414-8, 2009; Flex E., et al. J Exp Med. 205:751-8, 2008). In otherautoimmune diseases and cancers elevated systemic levels of inflammatorycytokines that activate JAK1 may also contribute to the disease and/orassociated symptoms. Therefore, patients with such diseases may benefitfrom JAK1 inhibition. Selective inhibitors of JAK1 may be efficaciouswhile avoiding unnecessary and potentially undesirable effects ofinhibiting other JAK kinases.

Selective inhibitors of JAK1, relative to other JAK kinases, may havemultiple therapeutic advantages over less selective inhibitors. Withrespect to selectivity against JAK2, a number of important cytokines andgrowth factors signal through JAK2 including, for example,erythropoietin (Epo) and thrombopoietin (Tpo) (Parganas E, et al. Cell.93:385-95, 1998). Epo is a key growth factor for red blood cellsproduction; hence a paucity of Epo-dependent signaling can result inreduced numbers of red blood cells and anemia (Kaushansky K, NEJM354:2034-45, 2006). Tpo, another example of a JAK2-dependent growthfactor, plays a central role in controlling the proliferation andmaturation of megakaryocytes—the cells from which platelets are produced(Kaushansky K, NEJM 354:2034-45, 2006). As such, reduced Tpo signalingwould decrease megakaryocyte numbers (megakaryocytopenia) and lowercirculating platelet counts (thrombocytopenia). This can result inundesirable and/or uncontrollable bleeding. Reduced inhibition of otherJAKs, such as JAK3 and Tyk2, may also be desirable as humans lackingfunctional version of these kinases have been shown to suffer fromnumerous maladies such as severe-combined immunodeficiency orhyperimmunoglobulin E syndrome (Minegishi, Y, et al. Immunity 25:745-55,2006; Macchi P, et al. Nature. 377:65-8, 1995). Therefore a JAK1inhibitor with reduced affinity for other JAKs would have significantadvantages over a less-selective inhibitor with respect to reduced sideeffects involving immune suppression, anemia and thrombocytopenia.

Another aspect of the present invention pertains to methods of treatinga JAK-associated disease or disorder in an individual (e.g., patient) byadministering to the individual in need of such treatment asustained-release dosage form of the invention. A JAK-associated diseasecan include any disease, disorder or condition that is directly orindirectly linked to expression or activity of the JAK, includingoverexpression and/or abnormal activity levels. A JAK-associated diseasecan also include any disease, disorder or condition that can beprevented, ameliorated, or cured by modulating JAK activity.

Examples of JAK-associated diseases include diseases involving theimmune system including, for example, organ transplant rejection (e.g.,allograft rejection and graft versus host disease).

Further examples of JAK-associated diseases include autoimmune diseasessuch as multiple sclerosis, rheumatoid arthritis, juvenile arthritis,psoriatic arthritis, type I diabetes, lupus, psoriasis, inflammatorybowel disease, ulcerative colitis, Crohn's disease, myasthenia gravis,immunoglobulin nephropathies, myocarditis, autoimmune thyroid disorders,chronic obstructive pulmonary disease (COPD), and the like. In someembodiments, the autoimmune disease is an autoimmune bullous skindisorder such as pemphigus vulgaris (PV) or bullous pemphigoid (BP).

Further examples of JAK-associated diseases include allergic conditionssuch as asthma, food allergies, eszematous dermatitis, contactdermatitis, atopic dermatitis (atropic eczema), and rhinitis. Furtherexamples of JAK-associated diseases include viral diseases such asEpstein Barr Virus (EBV), Hepatitis B, Hepatitis C, HIV, HTLV 1,Varicella-Zoster Virus (VZV) and Human Papilloma Virus (HPV).

Further examples of JAK-associated disease include diseases associatedwith cartilage turnover, for example, gouty arthritis, septic orinfectious arthritis, reactive arthritis, reflex sympathetic dystrophy,algodystrophy, Tietze syndrome, costal athropathy, osteoarthritisdeformans endemica, Mseleni disease, Handigodu disease, degenerationresulting from fibromyalgia, systemic lupus erythematosus, scleroderma,or ankylosing spondylitis.

Further examples of JAK-associated disease include congenital cartilagemalformations, including hereditary chrondrolysis, chrondrodysplasias,and pseudochrondrodysplasias (e.g., microtia, enotia, and metaphysealchrondrodysplasia).

Further examples of JAK-associated diseases or conditions include skindisorders such as psoriasis (for example, psoriasis vulgaris), atopicdermatitis, skin rash, skin irritation, skin sensitization (e.g.,contact dermatitis or allergic contact dermatitis). For example, certainsubstances including some pharmaceuticals when topically applied cancause skin sensitization. In some embodiments, co-administration orsequential administration of at least one JAK inhibitor of the inventiontogether with the agent causing unwanted sensitization can be helpful intreating such unwanted sensitization or dermatitis. In some embodiments,the skin disorder is treated by topical administration of at least oneJAK inhibitor of the invention.

In further embodiments, the JAK-associated disease is cancer includingthose characterized by solid tumors (e.g., prostate cancer, renalcancer, hepatic cancer, pancreatic cancer, gastric cancer, breastcancer, lung cancer, cancers of the head and neck, thyroid cancer,glioblastoma, Kaposi's sarcoma, Castleman's disease, uterineleiomyosarcoma, melanoma etc.), hematological cancers (e.g., lymphoma,leukemia such as acute lymphoblastic leukemia (ALL), acute myelogenousleukemia (AML) or multiple myeloma), and skin cancer such as cutaneousT-cell lymphoma (CTCL) and cutaneous B-cell lymphoma. Example CTCLsinclude Sezary syndrome and mycosis fungoides.

In some embodiments, the dosage forms described herein, or incombination with other JAK inhibitors, such as those reported in U.S.Ser. No. 11/637,545, which is incorporated herein by reference in itsentirety, can be used to treat inflammation-associated cancers. In someembodiments, the cancer is associated with inflammatory bowel disease.In some embodiments, the inflammatory bowel disease is ulcerativecolitis. In some embodiments, the inflammatory bowel disease is Crohn'sdisease. In some embodiments, the inflammation-associated cancer iscolitis-associated cancer. In some embodiments, theinflammation-associated cancer is colon cancer or colorectal cancer. Insome embodiments, the cancer is gastric cancer, gastrointestinalcarcinoid tumor, gastrointestinal stromal tumor (GIST), adenocarcinoma,small intestine cancer, or rectal cancer.

JAK-associated diseases can further include those characterized byexpression of: JAK2 mutants such as those having at least one mutationin the pseudo-kinase domain (e.g., JAK2V617F); JAK2 mutants having atleast one mutation outside of the pseudo-kinase domain; JAK1 mutants;JAK3 mutants; erythropoietin receptor (EPOR) mutants; or deregulatedexpression of CRLF2.

JAK-associated diseases can further include myeloproliferative disorders(MPDs) such as polycythemia vera (PV), essential thrombocythemia (ET),myelofibrosis with myeloid metaplasia (MMM), primary myelofibrosis(PMF), chronic myelogenous leukemia (CML), chronic myelomonocyticleukemia (CMML), hypereosinophilic syndrome (HES), systemic mast celldisease (SMCD), and the like. In some embodiments, themyeloproliferative disorder is myelofibrosis (e.g., primarymyelofibrosis (PMF) or post polycythemia vera/essential thrombocythemiamyelofibrosis (Post-PV/ET MF)). In some embodiments, themyeloproliferative disorder is post-essential thrombocythemiamyelofibrosis (Post-ET). In some embodiments, the myeloproliferativedisorder is post polycythemia vera myelofibrosis (Post-PV MF).

In some embodiments, dosage forms described herein can be used to treatpulmonary arterial hypertension.

The present invention further provides a method of treatingdermatological side effects of other pharmaceuticals by administrationof the dosage forms of the invention. For example, numerouspharmaceutical agents result in unwanted allergic reactions which canmanifest as acneiform rash or related dermatitis. Example pharmaceuticalagents that have such undesirable side effects include anti-cancer drugssuch as gefitinib, cetuximab, erlotinib, and the like. The dosage formsof the invention can be administered systemically in combination with(e.g., simultaneously or sequentially) the pharmaceutical agent havingthe undesirable dermatological side effect.

Further JAK-associated diseases include inflammation and inflammatorydiseases. Example inflammatory diseases include sarcoidosis,inflammatory diseases of the eye (e.g., iritis, uveitis, scleritis,conjunctivitis, or related disease), inflammatory diseases of therespiratory tract (e.g., the upper respiratory tract including the noseand sinuses such as rhinitis or sinusitis or the lower respiratory tractincluding bronchitis, chronic obstructive pulmonary disease, and thelike), inflammatory myopathy such as myocarditis, and other inflammatorydiseases. In some embodiments, the inflammation disease of the eye isblepharitis.

The dosage forms described herein can further be used to treat ischemiareperfusion injuries or a disease or condition related to aninflammatory ischemic event such as stroke or cardiac arrest. The dosageforms described herein can further be used to treat endotoxin-drivendisease state (e.g., complications after bypass surgery or chronicendotoxin states contributing to chronic cardiac failure). The dosageforms described herein can further be used to treat anorexia, cachexia,or fatigue such as that resulting from or associated with cancer. Thedosage forms described herein can further be used to treat restenosis,sclerodermitis, or fibrosis. The dosage forms described herein canfurther be used to treat conditions associated with hypoxia orastrogliosis such as, for example, diabetic retinopathy, cancer, orneurodegeneration. See, e.g., Dudley, A. C. et al. Biochem. J. 2005,390(Pt 2):427-36 and Sriram, K. et al. J. Biol. Chem. 2004, 279(19):19936-47. Epub 2004 Mar. 2, both of which are incorporated herein byreference in their entirety. The JAK inhibitors described herein can beused to treat Alzheimer's disease.

The dosage forms described herein can further be used to treat otherinflammatory diseases such as systemic inflammatory response syndrome(SIRS) and septic shock.

The dosage forms described herein can further be used to treat gout andincreased prostate size due to, e.g., benign prostatic hypertrophy orbenign prostatic hyperplasia.

Further JAK-associated diseases include bone resorption diseases such asosteoporosis, osteoarthritis. Bone resorption can also be associatedwith other conditions such as hormonal imbalance and/or hormonaltherapy, autoimmune disease (e.g. osseous sarcoidosis), or cancer (e.g.myeloma). The reduction of the bone resorption due to the the compoundof Formula I can be about 10%, about 20%, about 30%, about 40%, about50%, about 60%, about 70%, about 80%, or about 90%.

In some embodiments, the dosage forms described herein can further beused to treat a dry eye disorder. As used herein, “dry eye disorder” isintended to encompass the disease states summarized in a recent officialreport of the Dry Eye Workshop (DEWS), which defined dry eye as “amultifactorial disease of the tears and ocular surface that results insymptoms of discomfort, visual disturbance, and tear film instabilitywith potential damage to the ocular surface. It is accompanied byincreased osmolarity of the tear film and inflammation of the ocularsurface.” Lemp, “The Definition and Classification of Dry Eye Disease:Report of the Definition and Classification Subcommittee of theInternational Dry Eye Workshop”, The Ocular Surface, 5(2), 75-92 April2007, which is incorporated herein by reference in its entirety. In someembodiments, the dry eye disorder is selected from aqueoustear-deficient dry eye (ADDE) or evaporative dry eye disorder, orappropriate combinations thereof. In some embodiments, the dry eyedisorder is Sjogren syndrome dry eye (SSDE). In some embodiments, thedry eye disorder is non-Sjogren syndrome dry eye (NSSDE).

In a further aspect, the present invention provides a method of treatingconjunctivitis, uveitis (including chronic uveitis), chorioditis,retinitis, cyclitis, sclieritis, episcleritis, or iritis; treatinginflammation or pain related to corneal transplant, LASIK (laserassisted in situ keratomileusis), photorefractive keratectomy, or LASEK(laser assisted sub-epithelial keratomileusis); inhibiting loss ofvisual acuity related to corneal transplant, LASIK, photorefractivekeratectomy, or LASEK; or inhibiting transplant rejection in a patientin need thereof, comprising administering to the patient a dosage formof the invention.

Additionally, the dosage forms of the invention, or in combination withother JAK inhibitors, such as those reported in U.S. Ser. No.11/637,545, which is incorporated herein by reference in its entirety,can be used to treat respiratory dysfunction or failure associated withviral infection, such as influenza and SARS.

In some embodiments, the present invention provides a dosage form asdescribed in any of the embodiments herein, for use in a method oftreating any of the diseases or disorders described herein. In someembodiments, the present invention provides the use of a dosage form asdescribed in any of the embodiments herein, for the preparation of amedicament for use in a method of treating any of the diseases ordisorders described herein.

In some embodiments, the present invention provides a dosage form asdescribed herein, or a pharmaceutically acceptable salt thereof, for usein a method of modulating JAK1. In some embodiments, the presentinvention also provides use of a dosage form as described herein, or apharmaceutically acceptable salt thereof, for the preparation of amedicament for use in a method of modulating JAK1.

As used herein, the term “individual” is a human. In some embodiments,the human is an adult subject.

As used herein, the term “treating” or “treatment” refers to one or moreof (1) inhibiting the disease; for example, inhibiting a disease,condition or disorder in an individual who is experiencing or displayingthe pathology or symptomatology of the disease, condition or disorder(i.e., arresting further development of the pathology and/orsymptomatology); and (2) ameliorating the disease; for example,ameliorating a disease, condition or disorder in an individual who isexperiencing or displaying the pathology or symptomatology of thedisease, condition or disorder (i.e., reversing the pathology and/orsymptomatology) such as decreasing the severity of disease.

Combination Therapies

One or more additional pharmaceutical agents such as, for example,chemotherapeutics, anti-inflammatory agents, steroids,immunosuppressants, as well as Bcr-Abl, Flt-3, RAF and FAK kinaseinhibitors such as, for example, those described in WO 2006/056399,which is incorporated herein by reference in its entirety, or otheragents can be used in combination with the dosage forms described hereinfor treatment of JAK-associated diseases, disorders or conditions. Theone or more additional pharmaceutical agents can be administered to apatient simultaneously or sequentially.

Example chemotherapeutics include proteosome inhibitors (e.g.,bortezomib), thalidomide, revlimid, and DNA-damaging agents such asmelphalan, doxorubicin, cyclophosphamide, vincristine, etoposide,carmustine, and the like.

Example steroids include coriticosteroids such as dexamethasone orprednisone.

Example Bcr-Abl inhibitors include the compounds, and pharmaceuticallyacceptable salts thereof, of the genera and species disclosed in U.S.Pat. No. 5,521,184, WO 04/005281, and U.S. Ser. No. 60/578,491, all ofwhich are incorporated herein by reference in their entirety.

Example suitable Flt-3 inhibitors include compounds, and theirpharmaceutically acceptable salts, as disclosed in WO 03/037347, WO03/099771, and WO 04/046120, all of which are incorporated herein byreference in their entirety.

Example suitable RAF inhibitors include compounds, and theirpharmaceutically acceptable salts, as disclosed in WO 00/09495 and WO05/028444, both of which are incorporated herein by reference in theirentirety.

Example suitable FAK inhibitors include compounds, and theirpharmaceutically acceptable salts, as disclosed in WO 04/080980, WO04/056786, WO 03/024967, WO 01/064655, WO 00/053595, and WO 01/014402,all of which are incorporated herein by reference in their entirety.

In some embodiments, one or more of the dosage forms of the inventioncan be used in combination with one or more other kinase inhibitorsincluding imatinib, particularly for treating patients resistant toimatinib or other kinase inhibitors.

In some embodiments, one or more dosage forms of the invention can beused in combination with a chemotherapeutic in the treatment of cancer,such as multiple myeloma, and may improve the treatment response ascompared to the response to the chemotherapeutic agent alone, withoutexacerbation of its toxic effects. Examples of additional pharmaceuticalagents used in the treatment of multiple myeloma, for example, caninclude, without limitation, melphalan, melphalan plus prednisone [MP],doxorubicin, dexamethasone, and Velcade (bortezomib). Further additionalagents used in the treatment of multiple myeloma include Bcr-Abl, Flt-3,RAF and FAK kinase inhibitors. Additive or synergistic effects aredesirable outcomes of combining a dosage form of the present inventionwith an additional agent. Furthermore, resistance of multiple myelomacells to agents such as dexamethasone may be reversible upon treatmentwith a dosage form of the present invention. The agents can be combinedwith the present compounds in a single or continuous dosage form, or theagents can be administered simultaneously or sequentially as separatedosage forms.

In some embodiments, a corticosteroid such as dexamethasone isadministered to a patient in combination with at the dosage form of theinvention where the dexamethasone is administered intermittently asopposed to continuously.

In some further embodiments, combinations of one or more JAK inhibitorsof the invention with other therapeutic agents can be administered to apatient prior to, during, and/or after a bone marrow transplant or stemcell transplant.

In some embodiments, the additional therapeutic agent is fluocinoloneacetonide (Retisert®), or rimexolone (AL-2178, Vexol, Alcon).

In some embodiments, the additional therapeutic agent is cyclosporine(Restasis®).

In some embodiments, the additional therapeutic agent is acorticosteroid. In some embodiments, the corticosteroid istriamcinolone, dexamethasone, fluocinolone, cortisone, prednisolone, orflumetholone.

In some embodiments, the additional therapeutic agent is selected fromDehydrex™ (Holles Labs), Civamide (Opko), sodium hyaluronate (Vismed,Lantibio/TRB Chemedia), cyclosporine (ST-603, Sirion Therapeutics),ARG101(T) (testosterone, Argentis), AGR1012(P) (Argentis), ecabet sodium(Senju-Ista), gefarnate (Santen), 15-(s)-hydroxyeicosatetraenoic acid(15(S)-HETE), cevilemine, doxycycline (ALTY-0501, Alacrity),minocycline, iDestrin™ (NP50301, Nascent Pharmaceuticals), cyclosporineA (Nova22007, Novagali), oxytetracycline (Duramycin, MOLI1901,Lantibio), CF101(2S,3S,4R,5R)-3,4-dihydroxy-5-[6-[(3-iodophenyl)methylamino]purin-9-yl]-N-methyl-oxolane-2-carbamyl,Can-Fite Biopharma), voclosporin (LX212 or LX214, Lux Biosciences),ARG103 (Agentis), RX-10045 (synthetic resolvin analog, Resolvyx), DYN15(Dyanmis Therapeutics), rivoglitazone (DE011, Daiichi Sanko), TB4(RegeneRx), OPH-01 (Ophtalmis Monaco), PCS101 (Pericor Science), REV1-31(Evolutec), Lacritin (Senju), rebamipide (Otsuka-Novartis), OT-551(Othera), PAI-2 (University of Pennsylvania and Temple University),pilocarpine, tacrolimus, pimecrolimus (AMS981, Novartis), loteprednoletabonate, rituximab, diquafosol tetrasodium (INS365, Inspire), KLS-0611(Kissei Pharmaceuticals), dehydroepiandrosterone, anakinra, efalizumab,mycophenolate sodium, etanercept (Embrel®), hydroxychloroquine, NGX267(TorreyPines Therapeutics), actemra, gemcitabine, oxaliplatin,L-asparaginase, or thalidomide.

In some embodiments, the additional therapeutic agent is ananti-angiogenic agent, cholinergic agonist, TRP-1 receptor modulator, acalcium channel blocker, a mucin secretagogue, MUC1 stimulant, acalcineurin inhibitor, a corticosteroid, a P2Y2 receptor agonist, amuscarinic receptor agonist, an mTOR inhibitor, another JAK inhibitor,Bcr-Abl kinase inhibitor, Flt-3 kinase inhibitor, RAF kinase inhibitor,and FAK kinase inhibitor such as, for example, those described in WO2006/056399, which is incorporated herein by reference in its entirety.In some embodiments, the additional therapeutic agent is a tetracyclinederivative (e.g., minocycline or doxycline). In some embodiments, theadditional therapeutic agent binds to FKBP12.

In some embodiments, the additional therapeutic agent is an alkylatingagent or DNA cross-linking agent; an anti-metabolite/demethylating agent(e.g., 5-flurouracil, capecitabine or azacitidine); an anti-hormonetherapy (e.g., hormone receptor antagonists, SERMs, or aromotaseinhibitor); a mitotic inhibitor (e.g. vincristine or paclitaxel); antopoisomerase (I or II) inhibitor (e.g. mitoxantrone and irinotecan); anapoptotic inducers (e.g. ABT-737); a nucleic acid therapy (e.g.antisense or RNAi); nuclear receptor ligands (e.g., agonists and/orantagonists: all-trans retinoic acid or bexarotene); epigenetictargeting agents such as histone deacetylase inhibitors (e.g.vorinostat), hypomethylating agents (e.g. decitabine); regulators ofprotein stability such as Hsp90 inhibitors, ubiquitin and/or ubiquitinlike conjugating or deconjugating molecules; or an EGFR inhibitor(erlotinib).

In some embodiments, the additional therapeutic agent(s) are demulcenteye drops (also known as “artificial tears”), which include, but are notlimited to, compositions containing polyvinylalcohol, hydroxypropylmethylcellulose, glycerin, polyethylene glycol (e.g. PEG400), orcarboxymethyl cellulose. Artificial tears can help in the treatment ofdry eye by compensating for reduced moistening and lubricating capacityof the tear film. In some embodiments, the additional therapeutic agentis a mucolytic drug, such as N-acetyl-cysteine, which can interact withthe mucoproteins and, therefore, to decrease the viscosity of the tearfilm.

In some embodiments, the additional therapeutic agent includes anantibiotic, antiviral, antifungal, anesthetic, anti-inflammatory agentsincluding steroidal and non-steroidal anti-inflammatories, andanti-allergic agents. Examples of suitable medicaments includeaminoglycosides such as amikacin, gentamycin, tobramycin, streptomycin,netilmycin, and kanamycin; fluoroquinolones such as ciprofloxacin,norfloxacin, ofloxacin, trovafloxacin, lomefloxacin, levofloxacin, andenoxacin; naphthyridine; sulfonamides; polymyxin; chloramphenicol;neomycin; paramomycin; colistimethate; bacitracin; vancomycin;tetracyclines; rifampin and its derivatives (“rifampins”); cycloserine;beta-lactams; cephalosporins; amphotericins; fluconazole; flucytosine;natamycin; miconazole; ketoconazole; corticosteroids; diclofenac;flurbiprofen; ketorolac; suprofen; cromolyn; lodoxamide; levocabastin;naphazoline; antazoline; pheniramine; or azalide antibiotic.

It is further appreciated that certain features of the invention, whichare, for clarity, described in the context of separate embodiments, canalso be provided in combination in a single embodiment (as if theembodiments of the specification are written as multiply dependentclaims).

Example 1. Preparation of Sustained Release Formulations

Sustained release tablets were prepared with the excipients being in theamounts shown in the table below. Protocol A was used for the SR1tablets, protocol B was used for the SR2 tablets, Protocol C was usedfor the SR3 tablets and the 25 mg SR tablets, and Protocol D was usedfor the SR4 tablets.

Protocol A:

Step 1. Individually screen the adipic acid salt of the compound ofFormula I, microcrystalline cellulose, hypromelloses (Methocel K100 LVand Methocel K4M), and lactose monohydrate.

Step 2. Transfer the screened material from Step 1 to a suitable blenderand mix.

Step 3. Transfer the blend from Step 2 to a suitable granulator and mix.

Step 4. Add purified water while mixing.

Step 5. Transfer the granules from Step 4 into a suitable dryer and dryuntil LOD is less than 3%.

Step 6. Screen the granules from Step 5.

Step 7. Mix screened Magnesium Stearate with granules in Step 6 in asuitable blender.

Step 8. Compress the final blend in Step 7 on a suitable rotary tabletpress.

Protocol B:

Step 1. Individually screen the adipic acid salt of the compound ofFormula I, microcrystalline cellulose, hypromellose and pregelatinizedstarch.

Step 2. Transfer the screened material from Step 1 to a suitable blenderand mix.

Step 3. Transfer the blend from Step 2 to a suitable granulator and mix.

Step 4. Add purified water while mixing.

Step 5. Transfer the granules from Step 4 into a suitable dryer and dryuntil LOD is less than 3%.

Step 6. Screen the granules from Step 5.

Step 7. Individually screened polyox, butylated hydroxytoluene andcolloidal silicone dioxide.

Step 8. Transfer the granules from Step 6 and material from Step 7 intoa suitable blender and mix.

Step 9. Add screened Magnesium Stearate to the material in Step 8 andcontinue blending.

Step 10. Compress the final blend in Step 9 on a suitable rotary tabletpress.

Protocol C:

Step 1. Individually screen lactose monohydrate, the adipic acid salt ofthe compound of Formula I, microcrystalline cellulose and hypromellosesthrough a suitable screen.

Step 2. Transfer the screened material from Step 1 to a suitable blenderand mix.

Step 3. Transfer the blend from Step 2 to a suitable granulator and mix.

Step 4. Add purified water while mixing.

Step 5. Screen wet granules through a suitable screen.

Step 6. Transfer the granules from Step 5 into a suitable dryer and dryuntil LOD is less than 3%.

Step 7. Mill the granules from Step 6.

Step 8. Mix screened magnesium stearate with granules in Step 7 in asuitable blender.

Step 9. Compress the final blend in Step 8 on a suitable rotary tabletpress.

Protocol D:

Step 1. Individually screen pregelatinized starch, the adipic acid saltof the compound of Formula I, hypromellose, and a portion of requiredmicrocrystalline cellulose through a suitable screen.

Step 2. Transfer the screened material from Step 1 to a suitable blenderand mix.

Step 3. Transfer the blend from Step 2 to a suitable granulator and mix.

Step 4. Add purified water while mixing.

Step 5. Screen wet granules through a suitable screen.

Step 6. Transfer the granules from Step 5 into a suitable dryer and dryuntil LOD is less than 3%.

Step 7. Mill the granules from Step 6.

Step 8. Screen the remaining portion of microcrystalline cellulose andhalf of the sodium bicarbonate.

Step 9. Transfer the milled granules from Step 7 and screened materialsfrom Step 8 into a suitable blender and mix.

Step 10. Screen the remaining portion of sodium bicarbonate and mix withblend in Step 9.

Step 11. Screen magnesium stearate and mix with blend in Step 10.

Step 12. Compress the final blend in Step 11 on a suitable rotary tabletpress.

SR1: Composition of 100 mg Sustained Release Tablets

Weight Composition Component Function (mg/tablet) (wt %) Adipic acidsalt of the Active   126.42 ^(a) 21.1 compound of Formula I ^(a)Microcrystalline Filler 60.0 10.0 Cellulose Hypromellose Release Control60.0 10.0 (Methocel K100LV) Hypromellose Release Control 60.0 10.0(Methocel K4M) Lactose Monohydrate Filler 290.58 48.4 Magnesium Stearate^(b) Lubricant  3.0 0.5 Purified Water ^(c) Granulating q.s. — LiquidTotal 600.0  100 ^(a) Conversion factor for adipate salt to free base is0.7911 ^(b) Added after granulation ^(c) Removed during processing

SR2: Composition of 100 mg Sustained Release Tablets

Weight Composition Component Function (mg/tablet) (wt %) Adipic acidsalt of the Active   126.4 ^(a) 21.1 compound of Formula I ^(a)Microcrystalline Filler 180.0 30.0 Cellulose Hypromellose Binder  6.01.0 (Methocel K100LV) Polyethylene Oxide Release Control 180.0 30.0(Polyox WRS 1105) ^(b) Pregelatinized Starch Filler 101.6 16.9 ColloidalSilicon Glidant  3.0 0.5 Dioxide ^(b) Butylated Antioxidant   0.0120.002 Hydroxytoluene ^(b) Magnesium Stearate ^(b) Lubricant  3.0 0.5Purified Water ^(c) Granulating q.s. — Liquid Total 600.0 100.0 ^(a)Conversion factor for adipate salt to free base is 0.7911 ^(b) Addedafter granulation ^(c) Removed during processing

SR3 (100 mg): Composition of 100 mg Sustained Release Tablets

Weight Composition Component Function (mg/tablet) (wt %) Adipic acidsalt of the Active   126.4 ^(a) 21.1 compound of Formula I ^(a)Microcrystalline Filler 108.0 18.0 Cellulose Hypromellose ReleaseControl  42.0 7.0 (Methocel K100LV) Hypromellose Release Control  30.05.0 (Methocel K4M) Lactose Monohydrate Filler 290.6 48.4 MagnesiumStearate ^(b) Lubricant  3.0 0.5 Purified Water ^(c) Granulating q.s. —Liquid Total 600.0 100.0 ^(a) Conversion factor for adipate salt to freebase is 0.7911 ^(b) Added after granulation ^(c) Removed duringprocessing

SR4: Composition of 100 mg Sustained Release Tablets

Weight Composition Excipient Function (mg/tablet) (wt %) Adipic acidsalt of the Active   126.4 ^(a) 21.1 compound of Formula I ^(a)Microcrystalline Filler 104.6 17.4 Cellulose ^(d) Hypromellose Release210.0 35.0 (Methocel K100LV) Control Pregelatinized Starch Filler  60.010.0 Sodium Bicarbonate ^(b) Gastric Floating  96.0 16.0 Aid MagnesiumStearate ^(b) Lubricant  3.0 0.5 Purified Water ^(c) Granulation q.s. —Liquid Total 600.0 100.0 ^(a) Conversion factor for adipate salt to freebase is 0.7911 ^(b) Added after granulation ^(c) Removed duringprocessing ^(d) Partial added before and partial added after granulation

25 mg SR: Composition of 25 mg Sustained Release Tablets

Weight Composition Component Function (mg/tablet) (wt %) Adipic acidsalt of the Active   31.6 ^(a) 12.6 compound of Formula I ^(a)Microcrystalline Filler 105.0  42.0 Cellulose Hypromellose, ReleaseControl 25.0 10.0 (Methocel K100LV) Hypromellose, Release Control 25.010.0 (Methocel K4M) Lactose Monohydrate Filler  62.15 24.9 MagnesiumStearate ^(b) Lubricant  1.25 0.5 Purified Water ^(c) Granulating q.s. —Liquid Total 250 100.0 ^(a) Conversion factor for adipate salt to freebase is 0.7911 ^(b) Added after granulation ^(c) Removed duringprocessing

Example 2. Preparation of the IR Formulation of the Compound of FormulaI

The IR formulation used in the studies in Example 3 was prepared as 50mg capsules with the composition shown in the table below according toProtocol E below.

Protocol E:

Step 1. Pre-mix the required amount of the adipic acid salt of thecompound of Formula I and an approximately equal amount of silicifiedmicrocrystalline cellulose (SMCC).Step 2. Pass the mixture in Step 1 through a suitable screen (forexample 40 mesh).Step 3. Screen the remaining SMCC through the same screen used in Step2.Step 4. Blend the screened SMCC from Step 3 along with mixture from Step2 in a suitable blender (for example Turbula blender) for approximately5 minutes.Step 5. Fill the blend into capsules to desired fill weight.

WEIGHT QUANTITY COMPOSITION PER UNIT INGREDIENT (%) (mg) Adipic acidsalt of the compound 35.11 63.20* of Formula I SilicifiedMicrocrystalline Cellulose, 64.89 116.80 NF (Prosolv SMCC HD 90) TOTAL100.00% 180.00 #2 Capsules, Hard Gelatin, White NA 1 each Opaque *Adipicacid salt of the compound of Formula I with salt conversion factor of0.7911

Example 3. Relative Bioavailability Study of Sustained Release DosageForms

A total of 72 healthy adult subjects were enrolled in 6 cohorts (12subjects per cohort) and randomized to treatment sequences within eachcohort according to a randomization schedule. All treatments weresingle-dose administrations of the compound of Formula I. There was awashout period of 7 days between the treatment periods.

The SR1, SR2, SR3, and SR4 formulations were evaluated in Cohort 1,Cohort 2, Cohort 3, and Cohort 4, respectively (see Example 1 for SR1,SR2, SR3, SR4, and 25 mg SR tablets used in study). The subjectsreceived the IR and SR treatments according to a 3-way crossover design:

Treatment A: 300 mg (6×50 mg capsule) IR formulation of the compound ofFormula I administered orally after an overnight fast of at least 10hours.

Treatment B: 300 mg (3×100 mg tablets) SR formulation of the compound ofFormula I administered orally after an overnight fast of at least 10hours.

Treatment C: 300 mg (3×100 mg tablets) SR formulation of the compound ofFormula I administered orally after a high-fat meal.

The subjects in Cohort 5 received the following treatments in a 2-waycrossover design:

Treatment A: 300 mg (3×100 mg tablets of the compound of Formula I) SR3administered orally after an overnight fast of at least 10 hours.

Treatment B: 300 mg (3×100 mg tablets of the compound of Formula I) SR3administered orally after a medium-fat meal.

The subjects in Cohort 6 received the following treatments in a 3-waycrossover design:

Treatment A: 50 mg (2×25 mg tablets of the compound of Formula I (25 mgSR tablets from Example 1)) administered orally after an overnight fastof at least 10 hours.

Treatment B: 50 mg (2×25 mg tablets of the compound of Formula I (25 mgSR tablets from Example 1)) administered orally after a high-fat meal.

Treatment C: 100 mg (1×100 mg tablets) SR3 administered orally after anovernight fast of at least 10 hours.

Blood samples for determination of plasma concentrations of the compoundof Formula I were collected using lavender top (K2EDTA) Vacutainer®tubes at 0, 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 16, 24, 36, and 48hours post dose.

Plasma samples were assayed by a validated, GLP, LC/MS/MS method with alinear range of 5.0 to 5000 nM. Table 1 summarizes the accuracy andprecision (CV %) of the assay quality control samples during theanalysis of the plasma samples from this study.

TABLE 1 Accuracy and Precision of the Plasma Assay Quality ControlSamples Analyte Low QC Middle QC High QC (Unit) Theo Accuracy CV % TheoAccuracy CV % Theo Accuracy CV % Compound 15.0 99.0% 4.6% 250 101% 4.2%4000 99.5% 2.2% of Formula I CV % = percent coefficient of variability;QC = quality control; Theo = theoretical or nominal concentration.

For the PK analysis, the actual sample collection times were used. Forany sample with missing actual collection time, the scheduled time wasused provided that there was no protocol deviation noted for thecollection of these samples.

Standard noncompartmental PK methods were used to analyze the data forthe plasma concentration of the compound of Formula using PhoenixWinNonlin version 6.0 (Pharsight Corporation, Mountain View, Calif.).Thus, C_(max) and T_(max) were taken directly from the observed plasmaconcentration data. The terminal-phase disposition rate constant (λ_(z))was estimated using a log-linear regression of the concentration data inthe terminal disposition phase, and t_(1/2) was estimated asln(2)/λ_(z). AUC_(0-t) was estimated using the linear trapezoidal rulefor increasing concentrations and the log-trapezoidal rule fordecreasing concentrations, and the total AUC_(0-∞) was calculated asAUC_(0-t)+C_(t)/λ_(z). The oral-dose clearance (CL/F) was estimated asDose/AUC_(0-∞), and the terminal-phase volume of distribution (V_(z)/F)was estimated as Dose/[AUC_(0-∞)*λ_(z)].

The log-transformed C_(max) and AUC values (after dose normalization,where the doses were different) were compared between the fasted and feddosing treatments, and between the SR and IR dosing treatments, using acrossover ANOVA (fixed factor=treatment, sequence and period, randomeffect=subject (sequence)). The adjusted geometric mean ratios ofC_(max) and AUC between the treatments (reference=IR or fastedadministration of SR) and the corresponding 90% confidence intervals(CIs) were determined. In addition, the correlation between the observedfood effect of a high-fat meal on AUC_(0-∞) and the relativebioavailability of the SR formulations (with reference to the IRcapsule) were explored by a quantile plot using the data from allsubjects who completed Treatment A, B, and C in Cohorts 1 to 4. Thestatistical analysis was performed using Phoenix WinNonlin version 6.0.

FIG. 1 presents plasma concentrations of the compound of Formula I(mean±SE) for the subjects in Cohorts 1 to 4 following Treatment A (300mg IR administration in fasted state), Treatment B (300 mg SRadministration in fasted state), and Treatment C (300 mg SRadministration with a high-fat meal). FIG. 2 compares the effect of ahigh-fat meal and medium-fat meal on the mean PK profile following asingle-dose 300 mg (3×100 mg) administration of the compound of FormulaI SR3 tablets. FIG. 3 presents plasma concentrations of the compound ofFormula I (mean±SE) for the subjects in Cohort 6 following Treatment A(2×25 mg SR tablet administration in fasted state), Treatment B (2×25 mgSR tablet with a high-fat meal), and Treatment C (1×100 mg SR3administration in fasted state).

Tables 2A, 2B, 3A and 3B summarize mean PK parameters for subjects inCohorts 1 to 4, the relative bioavailability (reference=IR capsule) andfood effect (high-fat meal) for the 100 mg strength SR1-SR4 tablets.Table 4A and 4B summarize mean PK parameters for subjects in Cohort 5,and food effect (medium-fat meal) for the 100 mg strength SR3 tablet.Table 5A and 5B summarizes mean PK parameters for subjects in Cohort 6,the dose-normalized relative bioavailability (reference=100 mg SR3tablet), and the food effect (high-fat meal) for the 25 mg SR tablet.

TABLE 2A Cohort/ C_(max) T_(max) C_(max)/ t_(1/2) Treatment n (μM) (h)C_(12 h) (h) Cohort 1 300 mg IR 12  2.29 ± 0.50 1.0  197 ± 147  2.0 ±0.27 (fasted) 2.24  (0.50-2.0) 159   2.0 300 mg SR1 12 0.341 ± 0.13 1.313.2 ± 7.8 9.2 ± 4.5 (fasted) 0.317 (0.50-3.0) 11.6 8.3 300 mg SR1 120.610 ± 0.14 4.0 18.0 ± 6.4 3.2 ± 1.4 (high-fat 0.595  (2.0-8.0) 16.83.0 meal) Cohort 2 300 mg IR 12  2.05 ± 0.67 1.0  130 ± 72.9  2.1 ± 0.34(fasted) 1.92  (0.50-3.0) 112   2.1 300 mg SR2 12 0.191 ± 0.10 2.5 11.4± 9.9  11 ± 8.4 (fasted) 0.172  (1.0-4.0)  8.60  9.23 300 mg SR2 120.470 ± 0.16 6.0 11.0 ± 4.0 3.5 ± 2.6 (high-fat 0.443  (1.5-6.0) 10.43.0 meal) Cohort 3 300 mg IR 11  2.35 ± 0.41 1.0  136 ± 70.8  2.2 ± 0.53(fasted) 2.31  (0.50-2.0) 120   2.2 300 mg SR3 11 0.553 ± 0.24 1.5  22.9± 13.4 9.8 ± 8.5 (fasted) 0.502 (0.50-3.0) 19.3 7.2 300 mg SR3 12  1.05± 0.47 4.0  34.9 ± 15.8 3.3 ± 1.2 (high-fat 0.968  (1.5-8.0) 30.8 3.1meal) Cohort 4 300 mg IR 12  2.94 ± 0.98 1.0  170 ± 58.6  2.1 ± 0.58(fasted) 2.78  (0.25-1.5) 162   2.1 300 mg SR4 12 0.321 ± 0.27 2.0 10.3± 6.0 7.3 ± 5.3 (fasted) 0.249  (1.5-8.1)  8.92 6.0 300 mg SR4 12 0.549± 0.28 4.0  12.8 ± 14.8 4.9 ± 2.6 (high-fat 0.481  (2.0-16)  6.06 4.4meal)

TABLE 2B Cohort/ AUC_(0-t) AUC_(0-∞) CL/F Treatment (μM*h) (μM*h) (L/h)Cohort 1 300 mg IR 4.43 ± 1.00 4.45 ± 1.00 127 ± 27.1 (fasted) 4.33 4.35124 300 mg SR1 1.55 ± 0.54 1.65 ± 0.54 359 ± 106  (fasted) 1.47 1.57 345300 mg SR1 2.88 ± 0.65 2.91 ± 0.65 194 ± 39.9 (high-fat meal) 2.82 2.85190 Cohort 2 300 mg IR 4.45 ± 1.36 4.47 ± 1.36 134 ± 50.1 (fasted) 4.244.27 127 300 mg SR2 1.00 ± 037 1.17 ± 0.43 510 ± 148  (fasted) 0.95 1.11488 300 mg SR2 2.48 ± 0.70 2.52 ± 0.72 235 ± 83.5 (high-fat meal) 2.382.42 224 Cohort 3 300 mg IR 5.00 ± 1.33 5.03 ± 1.34 115 ± 32.4 (fasted)4.83 4.87 111 300 mg SR3 2.28 ± 0.71 2.39 ± 0.70 248 ± 82.8 (fasted)2.17 2.29 236 300 mg SR3 3.55 ± 1.13 3.59 ± 1.13 165 ± 50.2 (high-fatmeal) 3.40 3.44 158 Cohort 4 300 mg IR 5.23 ± 2.16 5.25 ± 2.15 117 ±39.8 (fasted) 4.88 4.90 111 300 mg SR4 1.61 ± 1.23 1.70 ± 1.25 456 ±259  (fasted) 1.31 1.40 387 300 mg SR4 3.00 ± 1.17 3.13 ± 1.20 200 ±80.0 (high-fat meal) 2.78 2.92 186

TABLE 3A Cohort/ C_(max) T_(max) C_(max)/ t_(1/2) Treatment (μM) (h)C_(12 h) (h) SR1 fasted vs IR 14.2%  (11.4%-17.5%) SR1 fed vs fasted188% (152%-232%) SR2 fasted vs IR  8.9%  (6.7%-11.9%) SR2 fed vs fasted258% (193%-344%) SR3 fasted vs IR 22.3%  (17.4%-28.6%) SR3 fed vs fasted191% (150%-244%) SR4 fasted vs IR  9.0%  (6.8%-11.9%) SR4 fed vs fasted193% (146%-256%) PK parameter values are mean ± SD and geometric meanexcept for T_(max), where median (90% confidence interval) is reported.

TABLE 3B Cohort/ AUC_(0-t) AUC_(0-∞) CL/F Treatment (μM*h) (μM*h) (L/h)Geometric Mean Relative Bioavailability and the 90% Confidence IntervalsSR1 fasted vs IR 34.1%  36.1%  (31.3%-37.0%) (33.3%-39.2%) SR1 fed vsfasted 191% 181% (176%-208%) (167%-196%) SR2 fasted vs IR 22.4%  26.0% (18.3%-27.4%) (21.6%-31.3%) SR2 fed vs fasted 250% 218% (204%-306%)(181%-262%) SR3 fasted vs IR 45.4%  47.5%  (39.6%-52.0%) (41.9%-53.9%)SR3 fed vs fasted 151% 145% (132%-173%) (128%-164%) SR4 fasted vs IR26.9%  28.5%  (21.6%-33.4%) (23.2%-35.1%) SR4 fed vs fasted 213% 215%(171%-264%) (172%-268%) PK parameter values are mean ± SD and geometricmean except for T_(max), where median (90% confidence interval) isreported.

TABLE 4A Cohort/ C_(max) T_(max) C_(max)/ t_(1/2) Treatment n (μM) (h)C_(12 h) (h) Cohort 5 300 mg 12 0.619 ± 0.41 1.75 22.8 ± 16.7 7.7 ± 5.2SR3 0.523 (0.50-4.0)  17.8 6.2 (fasted) 300 mg 12 0.875 ± 0.47 2.5  40.6± 22.7 3.6 ± 2.0 SR3 0.764 (1.5-6.0) 31.2 3.3 (medium- fat meal)Geometric Mean Relative Bioavailability and the 90% Confidence IntervalsSR3 146% fed vs (105%-202%) fasted Pharmacokinetic parameter values aremean ± SD and geometric mean except for T_(max), where median (90%confidence interval) is reported.

TABLE 4B Cohort/ AUC_(0-t) AUC_(0-∞) CL/F Treatment (μM*h) (μM*h) (L/h)Cohort 5 300 mg SR3 2.46 ± 1.13 2.58 ± 1.12 251 ± 105  (fasted) 2.232.36 230 300 mg SR3 2.98 ± 1.34 3.02 ± 1.35 215 ± 94.2 (medium-fat 2.722.76 196 meal) Geometric Mean Relative Bioavailability and the 90%Confidence Intervals SR3 fed vs 122% 117% fasted (102%-146%)(99.9%-137%) Pharmacokinetic parameter values are mean ± SD andgeometric mean except for T_(max), where median (90% confidenceinterval) is reported.

TABLE 5A Cohort/ C_(max) T_(max) C_(max)/ t_(1/2) Treatment n (nM) (h)C_(12 h) (h) Cohort 6 2 × 25 mg SR3 12 55.1 ± 30.3 1.3 NR 4.0 ± 2.6(fasted) 48.0 (0.50-4.0) 3.4 2 × 25 mg SR3 12 80.3 ± 27.3 3.0 NR 2.2 ±0.4 (high-fat meal) 76.7  (1.5-6.0) 2.2 1 × 100 mg SR3 11 174 ± 69.5 1.8NR 3.0 ± 1.3 (fasted) 161 (0.50-4.0) 2.7 Geometric Mean RelativeBioavailability and the 90% Confidence Confidence Intervals 2 × 25 mgSR3 160% fed vs fasted (129%-199%) 2 × 25 mg SR3 58.7%^(i)) vs 1 × 100mg SR3 (46.9%-73.5%) (fasted) NC = not calculated because of significantnumbers of mismatching T_(last) within the subjects between treatments;NR = not reported because significant numbers of C_(12 h) values wereBQL. PK parameter values are mean ± SD and geometric mean except forT_(max), where median (90% confidence interval) is reported.^(i))Statistical comparison was dose-normalized.

TABLE 5B Cohort/ AUC_(0-t) AUC_(0-∞) CL/F Treatment (nM*h) (nM*h) (L/h)Cohort 6 2 × 25 mg SR3 205 ± 103 243 ± 99.9 429 ± 167  (fasted) 183 226400 2 × 25 mg SR3 333 ± 104 376 ± 94.6 253 ± 57.7 (high-fat meal) 319366 247 1 × 100 mg SR3 671 ± 230 704 ± 230  280 ± 81.5 (fasted) 639 673268 Geometric Mean Relative Bioavailability and the 90% ConfidenceIntervals 2 × 25 mg SR3 174% 158% fed vs fasted (150%-202%) (138%-182%)2 × 25 mg SR3 NC 66.1%^(i)) vs 1 × 100 mg SR3 (57.5%-75.9% (fasted) NC =not calculated because of significant numbers of mismatching T_(last)within the subjects between treatments; NR = not reported becausesignificant numbers of C_(12 h) values were BQL. PK parameter values aremean ± SD and geometric mean except for T_(max), where median (90%confidence interval) is reported. ^(i))Statistical comparison wasdose-normalized.

The mean PK profiles following the fasting single-dose administration of300 mg IR capsules were similar among the subjects in Cohorts 1 to 4(FIG. 1). Compared to the IR formulation, following fasting single-doseadministration of the SR1-SR4 formulations (3×100 mg tablets), theobserved plasma median T_(max) values were moderately prolonged (by 0.3to 1.5 hours) with significantly reduced mean C_(max) values (the upperbounds of the 90% CI for the geometric mean C_(max) ratios were <30%),suggesting decreased absorption rate of the compound of Formula I forthe SR tablets. The apparent mean disposition t_(1/2) observed in theterminal phase was significantly longer, ranging from 7.3 to 11 hoursfor SR1-SR4, as compared to about 2 hours for the IR capsule, indicatingthat the systemic elimination of the compound of Formula I was likelyrate-limited by its absorption, which was sustained in the terminaldisposition phase. As a result of lower C_(max) and longer dispositiont_(1/2), the C_(max)/C_(12h) ratios were significantly lower for the SRtablets compared to the IR capsule for the same subjects studied. Thegeometric mean C_(max)/C_(12h) ratios were 11.6-, 8.6-, 19.3-, and8.9-fold, respectively, for SR1, SR2, SR3, and SR4 tablets, as comparedto 112- to 162-fold for the IR capsules administered in the fastedstate.

For administration in the fasted state, the 4 SR tablets showed reducedrelative bioavailability compared to the IR capsule dosed in the samesubjects. The percent geometric mean ratios (90% CI) of C_(max) were14.2% (11.4%-17.5%), 8.9% (6.7%-11.9%), 22.3% (17.4%-28.6%) and 9.0%(6.8%-11.9%) for SR1, SR2, SR3, and SR4, respectively. The percentgeometric mean ratios (90% CI) of AUC_(0-∞) were 36.1% (33.3%-39.2%),26.0% (21.6%-31.3%), 47.5% (41.9%-53.9%), and 28.5% (23.2%-35.1%) forSR1, SR2, SR3, and SR4, respectively. SR3 and SR1 demonstrated the bestand second best relative bioavailability, respectively, among the SRformulations tested.

Dosed in the fasted state, the intersubject variability as measured bypercent coefficient of variability (CV %) in plasma exposure wassignificantly higher for the gastroretentive formulation SR4, butcomparable among the 3 regular SR tablets designed for intestinalrelease. The intersubject CV % for the 100 mg SR1 tablet was 39% and 33%for C_(max) and AUC_(0-∞), respectively. The intersubject CV % for the100 mg SR2 tablet was 50% and 37% for C_(max) and AUC_(0-∞),respectively. The intersubject CV % for the 100 mg SR3 tablet was 43%and 29% for C_(max) and AUC_(0-∞), respectively. The intersubject CV %for the 100 mg SR4 tablet was 83% and 73% for C_(max) and AUC_(0-∞),respectively. Pooling all subjects in Cohorts 1-5 (n=59) who wereadministered 300 mg IR in the fasted state, the intersubject CV % was49% and 39% for C_(max) and AUC_(0-∞), respectively, comparable to theCV % values observed for SR1, SR2, and SR3.

A positive food effect was observed for all SR formulations studied atthe 300 mg (3×100 mg) dose level. Administered after a high-fat meal,geometric mean C_(max) and AUC_(0-∞) values increased by 88% and 81%,respectively, for SR1; by 158% and 118%, respectively; for SR2; by 91%and 45%; respectively; for SR3; and by 93% and 115%; respectively; forSR4. The food effect was moderate for a medium-fat meal as compared to ahigh-fat meal, as suggested by the data for SR3 in Cohort 5. For SR3,C_(max) and AUC_(0-∞) values increased by 46% and 17%, respectively,when it was administered following a standardized medium-fat meal.Administration with food did not significantly change the intersubjectCV % in compound of Formula I plasma exposure for SR1, SR2, and SR3,which are SR formulations designed for intra-intestinal release. ForSR4, which is a gastroretentive SR formulation, the intersubject CV % inplasma exposures appeared to be significantly reduced with a concomitanthigh-fat meal.

This study also explored the dose-normalized relative bioavailability ofthe 25 mg SR tablet in reference to the 100 mg SR3 tablet. For thesubjects in Cohort 6, the dose-normalized C_(max) and AUC_(0-∞) percentgeometric mean ratio for the 2×25 mg SR3 treatment was 59% and 66%,respectively, versus the 1×100 mg SR3 administration in the fastedstate. However, due to the supralinear dose-exposure relationship forthe compound of Formula I, the relative bioavailability of the 25 mg SRtablet may be underestimated. For the 2×25 mg SR dose, a high-fat mealincreased compound of Formula I C_(max) and AUC_(0-∞) by 60% and 58%,respectively.

For the four SR formulations evaluated, the observed apparentdisposition t₂ was comparable, and the C_(max)/C_(12h) ratios from afasting single-dose administration (which is used as a proxy for P/Tratio from twice-daily administration) were similar among SR1, SR2, andSR4 (˜10-fold) and moderately higher for SR3 (˜20-fold). Overall, all 4SR formulations demonstrated a significantly flatter PK profile comparedthe IR capsule, meeting an important objective for sustained release.Bioavailability of orally administered drug products may be defined bythe rate and extent of the drug absorption into systemic circulation. Areduction in drug absorption rate by limiting the drug release rate fromdrug products is a design requirement in sustained release formulations.Therefore, for SR formulations, the extent of the compound of Formula Iabsorption as measured by the plasma AUC_(0-∞) is used as the primaryendpoint to assess the relative bioavailability. Thus, the mean relativebioavailability is similar between SR2 (26%) and SR4 (29%), which wasslightly lower than that of SR1 (36%). The best relative bioavailabilitywas observed for SR3 (48%). The results are in line with the in vitrodissolution profiles obtained before conducting this study.

There was an apparent inverse correlation between the food effect andrelative bioavailability for the SR formulations. On average, dosed witha high-fat meal, the food-effect measured by the increase in AUC_(0-∞)was the greatest for SR2 (118%) and SR4 (115%), which was lower thanthat for SR1 (81%). The smallest food effect was observed for SR3 (45%).This correlation was also apparent when the data from all the subjectswere pooled together. A quantile plot using the pooled individual data(divided into 5 bins with 9 subjects per bin) suggests that the foodeffect was more significant (>2-fold increase in AUC) for the subjectswith relative bioavailability less than 35%, regardless of theformulation. The food effect was moderate (˜50% or less increase in AUC)for the subjects with relative bioavailability greater than 40%,regardless of formulation. SR3 delivered a mean relative bioavailabilityof 48% and is likely to be associated with a moderate food effect. Infact, when the SR3 tablet (3×100 mg) was dosed with a medium-fat meal(which is a more typical daily diet), the observed increase in geometricmean AUC_(0-∞) was only 17%, suggesting that this formulation may beadministered without regard to medium- or low-fat meals. From theperspective of avoiding significant food effect, SR3 is superior to theother formulations.

Example 4. Clinical Results in Phase 2a in Patients with ActiveRheumatoid Arthritis (RA)

An initial 28 day part of the study was conducted in order to selectdoses moving forward, guiding dose selection for the 3 month second partof the study. Part 2 of the study was randomized, double-blind, placebocontrolled (sponsor unblinded) with treatment for 84 days. Sixtysubjects to be randomized, using the same population as in Part 1:single cohort, five parallel treatment groups, 12 subjects each: 100 mgSR3 tablets BID; 300 mg (3×100 mg SR3 tablets) QD; 200 mg (2×100 mg SR3tablets) BID; 600 mg (6×100 mg SR3 tablets) QD; and placebo. Interimdata was submitted to ACR (American College of Rheumatology) 2013 (n=40subjects who completed day 84). The ACR scores at 3 months re shown inTable 6. The ACR scores for the 600 mg QD are unprecedented as comparedto other JAK inhibitors that are approved for treatment of RA. Forexample, the approved product for tofacitinib citrate (5 mg BID) showedmuch lower ACR scores at 3 months: 59% (ACR20), 31% (ACR50), and 15%(ACR70) (Table 5 of XELJANZ®—tofacitinib citrate tablet—label).

TABLE 6 100 mg 300 mg 200 mg 600 mg Placebo BID QD BID QD ACR20 38 50 4450 100 ACR50 25 38 44 38 71 ACR70 13 25 22 13 57

The percent change from baseline for hemoglobin was also studied foreach of the dosing regimens (FIG. 4A as a function of days; FIG. 4B as afunction of total average concentration (Cavg)). As can be seen in FIG.4A-B, the 200 mg BID dose showed a drop away from the baseline comparedto the other doses which tended to stay close to the placebo levels. Forexample, the 600 mg QD dose did not show the same downward trend asshown for the BID dose. However, as can be seen in Table 6, theonce-daily dosing (600 mg QD) did not compromise efficacy compared withthe BID doses. This indicates that the once-daily dosing (such as 600 mgQD) may achieve maximal efficacy without inducing side-effects suchanemia. As shown in FIG. 4 and Table 6, the 600 mg QD dose has robustefficacy with trivial change in hemoglobin levels.

It is believed that this efficacy/side-effect profile may be due to theQD dose achieving maximal JAK1 signaling (tied to efficacy) with lowJAK2 inhibition at the trough, as JAK2 signaling is tied tohematopoiesis. This hypothesis is supported by the PK derived JAK1(IL-6) and JAK2 (TPO) inhibition data for the compound of Formula atvarious doses (Table 7). In particular, the 600 mg QD dose showedsimilar average IL-6 inhibition to the 200 mg BID and 400 mg BID doses(61% versus 64% and 69%), but lower trough TPO inhibition in comparisonto the 200 mg BID and 400 mg BID doses (4% versus 13% and 16%). Thetrough IL-6 inhibition for the 600 mg QD dose is also lower than thetrough IL-6 inhibition for the 200 mg BID and 400 mg BID doses, whichsuggests that there may be a reduction in infection from the QD dose.

TABLE 7 Average Trough Average Trough IL-6 IL-6 TPO TPO Dose regimeninhibition inhibition inhibition inhibition 100 mg QD 30%  7%  7% <1% 200 mg QD 39% 11% 11% <1%  300 mg QD 47% 16% 18% 1% 600 mg QD 61% 31%36% 4% 100 mg BID 44% 22% 11% 2% 200 mg BID 64% 52% 24% 13%  400 mg BID69% 56% 33% 16% 

Example 5. Clinical Results in Patients with Plaque Psoriasis

A double-blind (sponsor unblinded), randomized, placebo controlled studywas conducted in approximately 48 subjects treated for 28 days.Eligibility requirements included: active plaque psoriasis for at least6 months at screening; body surface area (BSA) of plaque psoriasis of≥5%; psoriasis area and severity index (PASI) score of ≥5; staticphysician's global assessment (sPGA) score of ≥3; inadequate response totopical therapies; innovative design allowing rapid progress betweendoses, with conservative safety assessment. Four staggered dose groupsof 12 subjects each (9 active and 3 PBO) progressing from 100 mg QD to200 mg QD to 200 mg BID to 600 mg QD. Once the 4th subject (block of 3active 1 PBO) completed 28 days administration without a Grade 3 orhigher AE, the next group of 12 subjects initiated treatment with thenext highest dose; while the first 4 subjects in this group are treatedfor 28 days, the 1st group is filled 60 subjects with moderate to severepsoriasis were randomized. There were five treatment groups: placebo,100 mg QD, 200 mg QD, 200 mg BID and 600 mg QD. A sequential method ofrecruitment was used, increasing from the lowest dose to the highest,each after the completion of 28 days for the first four subjects in theprevious dose. The results at 28 days are show in Table 8 (PASI 50 isPsoriasis Area and Severity Index). These PASI 50 score of 81.8% for the600 mg QD dose are unprecedented as compared to other JAK inhibitorsthat are in development for treatment of psoriasis. For example, 5 mgtofacitinib (also known as tasocitinib) showed lower PASI 50 score of65.3% at 12 weeks (published on http://press.pfizer.com on Oct. 7,2010). The 5 mg tofacitinib dose is the approved dosage level for RA forsafety reasons in the US.

TABLE 8 100 mg 200 mg 200 mg 600 mg Placebo BID QD BID QD Mean % −12.5%−22.2% −29.4% −35.2% −42.4% change sPGA % sPGA 0 11.1% 22.2% 33.3% 45.5%(clear or minimal) % PASI 50 8.3% 22.2% 66.7% 44.4% 81.8%

Example 6. Open-Label Phase II Study in Patients with Myelofibrosis

In this study, patients with age ≥18 years, a diagnosis of primarymyelofibrosis (PMF) or post-polycythemia vera MF or post-essentialthrombocythemia MF (JAK2V617F positive or negative mutation status),platelet counts ≥50×109/L, hemoglobin levels ≥8.0 g/dL (transfusionspermitted to achieve these levels), intermediate-1 or higher per DIPSScriteria, and palpable spleen or prior splenectomy were enrolled. Threedifferent dose cohorts were assessed: (1) 100 mg SR3 tablets BID) (2)200 mg (2×100 mg SR3 tablets) BID; and (3) 600 mg (6×100 mg SR3 tablets)QD. FIG. 5A-B show interim results with respect to proportion ofsubjects with ≥50% reduction in total symptom score (TSS) in each dosegroup per the modified Myelofibrosis Symptom Assessment Form (MFSAF)v3.0 electronic diary at week 12 compared with baseline (The modifiedMFSAF v3.0 comprises 19 questions assessing MF-related symptoms on ascale of 0 (absent) to 10 (worst imaginable)). FIG. 5A depicts thepercentage of patients having a ≥50% reduction in TSS at week 12 by dosecohort (100 mg BID, 200 mg BID, and 600 mg QD) (patients whodiscontinued prior to the week 12 visit were considered nonresponders).FIG. 5B depicts the percent change in TSS from baseline at week 12 bydose cohort (100 mg BID, 200 mg BID, and 600 mg QD) (only patients withbaseline and week 12 data were included). FIG. 6A depicts meanhemoglobin levels (g/dL) over time by dose cohort (100 mg BID, 200 mgBID, and 600 mg QD) (interim results of study for all patients). FIG. 6Bdepicts mean hemoglobin levels (g/dL) over time by dose cohort (100 mgBID, 200 mg BID, and 600 mg QD) at 48 weeks. FIG. 6C depicts meanhemoglobin levels (g/dL) over time by dose cohort at 48 weeks as anaverage for three dose cohorts as compared to individuals dosed withplacebo or ruxolitinib (ruxolitinib was dosed according to the label forJakafi®). The data show an increase in hemoglobin levels for the 600 mgQD dose. Finally, Table 9 below show interim hematology laboratoryresults (new and worsening) for each dose cohort. Table 9a shows thehematology laboratory results (new and worsening) for each dose cohortafter long exposure.

TABLE 9 N % Event n 100 mg BID 200 mg BID 600 mg QD Days of Exposure,102.5 169.0 16.0 median (range) (23.0, 376.0) (22.0, 339.0) (1.0, 196.0)Anemia, Grade 3 3/9 (33.3) 12/42 (28.6) 2/29 (6.9) ThrombocytopeniaGrade 3 4/9 (44.4) 12/44 (27.3) 1/29 (3.4) Grade 4 0/9 (0)   2/45 (4.4)0/29 (0)  

TABLE 9a N % 100 mg BID 200 mg BID 600 mg QD Event n (N = 10) (N = 45)(N = 32) Days of Exposure, 102.0 254.0 192.0 median (range) (23, 519)(22, 535) (28, 343) Anemia, Grade 3 3/10 (30.0) 19/45 (42.2) 8/32 (25.0)Thrombocytopenia Grade 3 4/10 (40.0) 13/45 (28.9) 4/32 (12.5) Grade 40/10 (0.0)  3/45 (6.7) 1/32 (3.1) 

Example A: In Vitro JAK Kinase Assay

The compound of Formula I herein was tested for inhibitory activity ofJAK targets according to the following in vitro assay described in Parket al., Analytical Biochemistry 1999, 269, 94-104. The catalytic domainsof human JAK1 (a.a. 837-1142) and JAK2 (a.a. 828-1132) with anN-terminal His tag were expressed using baculovirus in insect cells andpurified. The catalytic activity of JAK1 and JAK2 was assayed bymeasuring the phosphorylation of a biotinylated peptide. Thephosphorylated peptide was detected by homogenous time resolvedfluorescence (HTRF). IC₅₀s of compounds were measured for each kinase inthe 40 microL reactions that contain the enzyme, ATP and 500 nM peptidein 50 mM Tris (pH 7.8) buffer with 100 mM NaCl, 5 mM DTT, and 0.1 mg/mL(0.01%) BSA. For the 1 mM IC₅₀ measurements, ATP concentration in thereactions was 1 mM. Reactions were carried out at room temperature for 1hr and then stopped with 20 μL 45 mM EDTA, 300 nM SA-APC, 6 nM Eu-Py20in assay buffer (Perkin Elmer, Boston, Mass.). Binding to the Europiumlabeled antibody took place for 40 minutes and HTRF signal was measuredon a Fusion plate reader (Perkin Elmer, Boston, Mass.). The compound ofFormula I and the adipic acid salt had an IC₅₀ at JAK1 of ≤5 nM(measured at 1 mM ATP) with a JAK2/JAK1 ratio of ≥10 (measured at 1 mMATP).

Example B: Cellular Assays

Cancer cell lines dependent on cytokines and hence JAK/STAT signaltransduction, for growth, can be plated at 6000 cells per well (96 wellplate format) in RPMI 1640, 10% FBS, and 1 nG/mL of appropriatecytokine. Compounds can be added to the cells in DMSO/media (finalconcentration 0.2% DMSO) and incubated for 72 hours at 37° C., 5% CO₂.The effect of compound on cell viability is assessed using theCellTiter-Glo Luminescent Cell Viability Assay (Promega) followed byTopCount (Perkin Elmer, Boston, Mass.) quantitation. Potentialoff-target effects of compounds are measured in parallel using a non-JAKdriven cell line with the same assay readout. All experiments aretypically performed in duplicate.

The above cell lines can also be used to examine the effects ofcompounds on phosphorylation of JAK kinases or potential downstreamsubstrates such as STAT proteins, Akt, Shp2, or Erk. These experimentscan be performed following an overnight cytokine starvation, followed bya brief preincubation with compound (2 hours or less) and cytokinestimulation of approximately 1 hour or less. Proteins are then extractedfrom cells and analyzed by techniques familiar to those schooled in theart including Western blotting or ELISAs using antibodies that candifferentiate between phosphorylated and total protein. Theseexperiments can utilize normal or cancer cells to investigate theactivity of compounds on tumor cell survival biology or on mediators ofinflammatory disease. For example, with regards to the latter, cytokinessuch as IL-6, IL-12, IL-23, or IFN can be used to stimulate JAKactivation resulting in phosphorylation of STAT protein(s) andpotentially in transcriptional profiles (assessed by array or qPCRtechnology) or production and/or secretion of proteins, such as IL-17.The ability of compounds to inhibit these cytokine mediated effects canbe measured using techniques common to those schooled in the art.

Compounds herein can also be tested in cellular models designed toevaluate their potency and activity against mutant JAKs, for example,the JAK2V617F mutation found in myeloid proliferative disorders. Theseexperiments often utilize cytokine dependent cells of hematologicallineage (e.g. BaF/3) into which the wild-type or mutant JAK kinases areectopically expressed (James, C., et al. Nature 434:1144-1148; Staerk,J., et al. JBC 280:41893-41899). Endpoints include the effects ofcompounds on cell survival, proliferation, and phosphorylated JAK, STAT,Akt, or Erk proteins.

Certain compounds herein can be evaluated for their activity inhibitingT-cell proliferation. Such as assay can be considered a second cytokine(i.e. JAK) driven proliferation assay and also a simplistic assay ofimmune suppression or inhibition of immune activation. The following isa brief outline of how such experiments can be performed. Peripheralblood mononuclear cells (PBMCs) are prepared from human whole bloodsamples using Ficoll Hypaque separation method and T-cells (fraction2000) can be obtained from PBMCs by elutriation. Freshly isolated humanT-cells can be maintained in culture medium (RPMI 1640 supplemented with10% fetal bovine serum, 100 U/ml penicillin, 100 μg/ml streptomycin) ata density of 2×10⁶ cells/ml at 37° C. for up to 2 days. For IL-2stimulated cell proliferation analysis, T-cells are first treated withPhytohemagglutinin (PHA) at a final concentration of 10 μg/mL for 72 h.After washing once with PBS, 6000 cells/well are plated in 96-wellplates and treated with compounds at different concentrations in theculture medium in the presence of 100 U/mL human IL-2 (ProSpec-TanyTechnoGene; Rehovot, Israel). The plates are incubated at 37° C. for 72h and the proliferation index is assessed using CellTiter-GloLuminescent reagents following the manufactory suggested protocol(Promega; Madison, Wis.).

Example C: In Vivo Anti-Tumor Efficacy

Compounds herein can be evaluated in human tumor xenograft models inimmune compromised mice. For example, a tumorigenic variant of the INA-6plasmacytoma cell line can be used to inoculate SCID mice subcutaneously(Burger, R., et al. Hematol J. 2:42-53, 2001). Tumor bearing animals canthen be randomized into drug or vehicle treatment groups and differentdoses of compounds can be administered by any number of the usual routesincluding oral, i.p., or continuous infusion using implantable pumps.Tumor growth is followed over time using calipers. Further, tumorsamples can be harvested at any time after the initiation of treatmentfor analysis as described above (Example B) to evaluate compound effectson JAK activity and downstream signaling pathways. In addition,selectivity of the compound(s) can be assessed using xenograft tumormodels that are driven by other know kinases (e.g. Bcr-Abl) such as theK562 tumor model.

Example D: Murine Skin Contact Delayed Hypersensitivity Response Test

Compounds herein can also be tested for their efficacies (of inhibitingJAK targets) in the T-cell driven murine delayed hypersensitivity testmodel. The murine skin contact delayed-type hypersensitivity (DTH)response is considered to be a valid model of clinical contactdermatitis, and other T-lymphocyte mediated immune disorders of theskin, such as psoriasis (Immunol Today. 1998 January; 19(1):37-44).Murine DTH shares multiple characteristics with psoriasis, including theimmune infiltrate, the accompanying increase in inflammatory cytokines,and keratinocyte hyperproliferation. Furthermore, many classes of agentsthat are efficacious in treating psoriasis in the clinic are alsoeffective inhibitors of the DTH response in mice (Agents Actions. 1993January; 38(1-2):116-21).

On Day 0 and 1, Balb/c mice are sensitized with a topical application,to their shaved abdomen with the antigen 2,4,dinitro-fluorobenzene(DNFB). On day 5, ears are measured for thickness using an engineer'smicrometer. This measurement is recorded and used as a baseline. Both ofthe animals' ears are then challenged by a topical application of DNFBin a total of 20 μL (10 μL on the internal pinna and 10 μL on theexternal pinna) at a concentration of 0.2%. Twenty-four to seventy-twohours after the challenge, ears are measured again. Treatment with thetest compounds is given throughout the sensitization and challengephases (day −1 to day 7) or prior to and throughout the challenge phase(usually afternoon of day 4 to day 7). Treatment of the test compounds(in different concentration) is administered either systemically ortopically (topical application of the treatment to the ears). Efficaciesof the test compounds are indicated by a reduction in ear swellingcomparing to the situation without the treatment. Compounds causing areduction of 20% or more were considered efficacious. In someexperiments, the mice are challenged but not sensitized (negativecontrol).

The inhibitive effect (inhibiting activation of the JAK-STAT pathways)of the test compounds can be confirmed by immunohistochemical analysis.Activation of the JAK-STAT pathway(s) results in the formation andtranslocation of functional transcription factors. Further, the influxof immune cells and the increased proliferation of keratinocytes shouldalso provide unique expression profile changes in the ear that can beinvestigated and quantified. Formalin fixed and paraffin embedded earsections (harvested after the challenge phase in the DTH model) aresubjected to immunohistochemical analysis using an antibody thatspecifically interacts with phosphorylated STAT3 (clone 58E12, CellSignaling Technologies). The mouse ears are treated with test compounds,vehicle, or dexamethasone (a clinically efficacious treatment forpsoriasis), or without any treatment, in the DTH model for comparisons.Test compounds and the dexamethasone can produce similar transcriptionalchanges both qualitatively and quantitatively, and both the testcompounds and dexamethasone can reduce the number of infiltrating cells.Both systemically and topical administration of the test compounds canproduce inhibitive effects, i.e., reduction in the number ofinfiltrating cells and inhibition of the transcriptional changes.

Example E: In Vivo Anti-Inflammatory Activity

Compounds herein can be evaluated in rodent or non-rodent modelsdesigned to replicate a single or complex inflammation response. Forinstance, rodent models of arthritis can be used to evaluate thetherapeutic potential of compounds dosed preventatively ortherapeutically. These models include but are not limited to mouse orrat collagen-induced arthritis, rat adjuvant-induced arthritis, andcollagen antibody-induced arthritis. Autoimmune diseases including, butnot limited to, multiple sclerosis, type I-diabetes mellitus,uveoretinitis, thyroditis, myasthenia gravis, immunoglobulinnephropathies, myocarditis, airway sensitization (asthma), lupus, orcolitis may also be used to evaluate the therapeutic potential ofcompounds herein. These models are well established in the researchcommunity and are familiar to those schooled in the art (CurrentProtocols in Immunology, Vol 3., Coligan, J. E. et al, Wiley Press.;Methods in Molecular Biology: Vol. 225, Inflammation Protocols.,Winyard, P. G. and Willoughby, D. A., Humana Press, 2003).

Example F: Animal Models for the Treatment of Dry Eye, Uveitis, andConjunctivitis

Agents may be evaluated in one or more preclinical models of dry eyeknown to those schooled in the art including, but not limited to, therabbit concanavalin A (ConA) lacrimal gland model, the scopolamine mousemodel (subcutaneous or transdermal), the Botulinumn mouse lacrimal glandmodel, or any of a number of spontaneous rodent autoimmune models thatresult in ocular gland dysfunction (e.g. NOD-SCID, MRL/lpr, or NZB/NZW)(Barabino et al., Experimental Eye Research 2004, 79, 613-621 andSchrader et al., Developmental Opthalmology, Karger 2008, 41, 298-312,each of which is incorporated herein by reference in its entirety).Endpoints in these models may include histopathology of the ocularglands and eye (cornea, etc.) and possibly the classic Schirmer test ormodified versions thereof (Barabino et al.) which measure tearproduction. Activity may be assessed by dosing via multiple routes ofadministration (e.g. systemic or topical) which may begin prior to orafter measurable disease exists.

Agents may be evaluated in one or more preclinical models of uveitisknown to those schooled in the art. These include, but are not limitedto, models of experimental autoimmune uveitis (EAU) and endotoxininduced uveitis (EIU). EAU experiements may be performed in the rabbit,rat, or mouse and may involve passive or activate immunization. Forinstance, any of a number or retinal antigens may be used to sensitizeanimals to a relevant immunogen after which animals may be challengedocuarly with the same antigen. The EIU model is more acute and involveslocal or systemic administration of lipopolysaccaride at sublethaldoses. Endpoints for both the EIU and EAU models may include fundoscopicexam, histopathology amongst others. These models are reviewed by Smithet al. (Immunology and Cell Biology 1998, 76, 497-512, which isincorporated herein by reference in its entirety). Activity is assessedby dosing via multiple routes of administration (e.g. systemic ortopical) which may begin prior to or after measurable disease exists.Some models listed above may also develop scleritis/episcleritis,chorioditis, cyclitis, or iritis and are therefore useful ininvestigating the potential activity of compounds for the therapeutictreatment of these diseases.

Agents may also be evaluated in one or more preclinical models ofconjunctivitis known those schooled in the art. These include, but arenot limited to, rodent models utilizing guinea-pig, rat, or mouse. Theguinea-pig models include those utilizing active or passive immunizationand/or immune challenge protocols with antigens such as ovalbumin orragweed (reviewed in Groneberg, D. A., et al., Allergy 2003, 58,1101-1113, which is incorporated herein by reference in its entirety).Rat and mouse models are similar in general design to those in theguinea-pig (also reviewed by Groneberg). Activity may be assessed bydosing via multiple routes of administration (e.g. systemic or topical)which may begin prior to or after measurable disease exists. Endpointsfor such studies may include, for example, histological, immunological,biochemical, or molecular analysis of ocular tissues such as theconjunctiva.

Example G: In Vivo Protection of Bone

Compounds may be evaluated in various preclinical models of osteopenia,osteoporosis, or bone resorption known to those schooled in the art. Forexample, ovariectomized rodents may be used to evaluate the ability ofcompounds to affect signs and markers of bone remodeling and/or density(W. S. S. Jee and W. Yao, J Musculoskel. Nueron. Interact., 2001, 1(3),193-207, which is incorporated herein by reference in its entirety).Alternatively, bone density and architecture may be evaluated in controlor compound treated rodents in models of therapy (e.g. glucocorticoid)induced osteopenia (Yao, et al. Arthritis and Rheumatism, 2008, 58(6),3485-3497; and id. 58(11), 1674-1686, both of which are incorporatedherein by reference in its entirety). In addition, the effects ofcompounds on bone resorption and density may be evaluable in the rodentmodels of arthritis discussed above (Example E). Endpoints for all thesemodels may vary but often include histological and radiologicalassessments as well as immunohisotology and appropriate biochemicalmarkers of bone remodeling.

1-45. (canceled)
 46. A method of treating a disease selected frompsoriasis, rheumatoid arthritis, primary myelofibrosis (PMF),post-polycythemia vera myelofibrosis, and post-essential thrombocythemiamyelofibrosis in a patient in need thereof, comprising orallyadministering to said patient a once-daily dose of one or more sustainedrelease tablets, each comprising: (i){1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof; (ii) a first hypromellosecharacterized by having an apparent viscosity at a concentration of 2%in water of 80 cP to 120 cP; (iii) a second hypromellose, characterizedby having an apparent viscosity at a concentration of 2% in water of3000 cP to 5600 cP, wherein the tablet comprises 8% to 20% of the firstand second hypromelloses; (iv) 16% to 22% by weight of microcrystallinecellulose; and (v) 45% to 55% by weight of lactose monohydrate; whereinoral administration of the one or more of the sustained release tabletsto a fasted individual provides a ratio of mean peak plasmaconcentration (C_(max)) to mean 12-hour plasma concentration (C_(12h))of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof 9 to
 40. 47. The method of claim 46, wherein oral administration ofthe one or more of the sustained release tablets to a fasted patientprovides a ratio of mean peak plasma concentration (C_(max)) to mean12-hour plasma concentration (C_(12h)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof 15 to
 30. 48. The method of claim 46, wherein oral administration ofthe one or more of the sustained release tablets to a patient after ahigh-fat meal provides a ratio of mean peak plasma concentration(C_(max)) to mean 12-hour plasma concentration (C_(12h)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof 10 to
 70. 49. The method of claim 46, wherein oral administration ofthe one or more of the sustained release tablets to a patient after ahigh-fat meal provides a ratio of mean peak plasma concentration(C_(max)) to mean 12-hour plasma concentration (C_(12h)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof 15 to
 50. 50. The method of claim 46, wherein oral administration ofthe one or more of the sustained release tablets to a patient after ahigh-fat meal provides a ratio of mean peak plasma concentration(C_(max)) to mean 12-hour plasma concentration (C_(12h)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof 25 to
 45. 51. A method of treating a disease selected from psoriasis,rheumatoid arthritis, primary myelofibrosis (PMF), post-polycythemiavera myelofibrosis, and post-essential thrombocythemia myelofibrosis ina patient in need thereof, comprising orally administering to saidpatient a once-daily dose of one or more sustained release tablets, eachcomprising{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof; and at least onesustained release matrix former, wherein: (a) oral administration of oneor more of the sustained release tablets to a fasted individual providesa mean peak plasma concentration (C_(max)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof 0.191 μM±0.10 μM; or (b) oral administration of one or more of thesustained release tablets to a fasted individual provides a mean time topeak plasma concentration (T_(max)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof 0.5 hours to 3 hours; or (c) oral administration of one or more ofthe sustained release tablets to a fasted individual provides a meanhalf-life (t_(1/2)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof 1 hour to 20 hours; or (d) oral administration of one or more of thesustained release tablets to an individual after a high-fat mealprovides a mean half-life (t_(1/2)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof 1 hour to 7 hours; or (e) any combination of (a)-(d).
 52. The methodof claim 51, wherein oral administration of the one or more of thesustained release tablets to a patient after a high-fat meal provides amean half-life (t_(1/2)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof 2 hour to 5 hours.
 53. The method of claim 51, wherein oraladministration of the one or more of the sustained release tablets to afasted patient provides a mean half-life (t_(1/2)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof 4.9 h+2.6 h.
 54. The method of claim 51, wherein oral administrationof the one or more of the sustained release tablets to a fasted patientprovides a mean peak plasma concentration (C_(max)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof 0.191 μM±0.10 μM.
 55. Method of claim 51, wherein oral administrationof the one or more of the sustained release tablets to a fasted patientprovides a mean time to peak plasma concentration (T_(max)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof 0.5 hours to 3 hours.
 56. The method of claim 51, wherein oraladministration of the one or more of the sustained release tablets to afasted patient provides a mean half-life (t_(1/2)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof 1 hour to 20 hours.
 57. The method of claim 51, wherein oraladministration of the one or more of the sustained release tablets to apatient after a high-fat meal provides a mean half-life (t_(1/2)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof 1 hour to 7 hours.
 58. The method of claim 46, wherein each of theone or more sustained release tablets comprises 10% to 15% of the firstand second hypromelloses.
 59. The method of claim 51, wherein the atleast one sustained release matrix former is a first hypromellose and asecond hypromellose, and wherein each sustained release tablet comprises10% to 15% of the first and second hypromelloses.
 60. The method ofclaim 46, wherein said salt is{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileadipic acid salt.
 61. The method of claim 51, wherein said salt is{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileadipic acid salt.
 62. A method of treating a disease selected frompsoriasis, rheumatoid arthritis, primary myelofibrosis (PMF),post-polycythemia vera myelofibrosis, and post-essential thrombocythemiamyelofibrosis in a patient in need thereof, comprising orallyadministering to said patient a once-daily dose of one or more sustainedrelease tablets, each comprising: (i){1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrile,or a pharmaceutically acceptable salt thereof; (ii) a first hypromellosecharacterized by having an apparent viscosity at a concentration of 2%in water of 80 cP to 120 cP; (iii) a second hypromellose, characterizedby having an apparent viscosity at a concentration of 2% in water of3000 cP to 5600 cP, wherein the tablet comprises 10% to 15% of the firstand second hypromelloses; (iv) 16% to 22% by weight of microcrystallinecellulose; and (v) 45% to 55% by weight of lactose monohydrate; wherein:(a) oral administration of the one or more of the sustained releasetablets to a fasted patient provides a ratio of mean peak plasmaconcentration (C_(max)) to mean 12-hour plasma concentration (C_(12h))of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof 15 to 30; or (b) oral administration of the one or more of thesustained release tablets to a fasted patient provides a mean time topeak plasma concentration (T_(max)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof 0.5 hours to 3 hours; or (c) oral administration of the one or moreof the sustained release tablets to a fasted patient provides a meanhalf-life (t_(1/2)) of{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileof 1 hour to 20 hours; or (d) any combination of (a), (b), and (c). 63.The method of claim 62, wherein said salt is{1-{1-[3-fluoro-2-(trifluoromethyl)isonicotinoyl]piperidin-4-yl}-3-[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl]azetidin-3-yl}acetonitrileadipic acid salt.
 64. The method of claim 46, wherein the disease ispsoriasis.
 65. A method according to claim 64, wherein the PsoriasisArea and Severity Index-50 score (PASI 50) is greater than about 70%.66. The method of claim 46, wherein the disease is rheumatoid arthritis.67. A method according to claim 66, wherein the American College ofRheumatology-70 score (ACR70) of said patient is greater than about 40%.68. A method according to claim 66, wherein the American College ofRheumatology-70 score (ACR70) of said patient is greater than about 50%.69. The method of claim 46, wherein the disease is primary myelofibrosis(PMF).
 70. A method according to claim 69, wherein the method results ina reduced total symptom score (TSS) of said patient compared withbaseline.
 71. A method according to claim 69, wherein said methodresults in reduced anemia.
 72. The method of claim 46, wherein thedisease is post-polycythemia vera myelofibrosis.
 73. The method of claim46, wherein the disease is post-essential thrombocythemia myelofibrosis.74. The method of claim 51, wherein the disease is psoriasis.
 75. Amethod according to claim 74, wherein the Psoriasis Area and SeverityIndex-50 score (PASI 50) is greater than about 70%.
 76. The method ofclaim 51, wherein the disease is rheumatoid arthritis.
 77. A methodaccording to claim 76, wherein the American College of Rheumatology-70score (ACR70) of said patient is greater than about 40%.
 78. A methodaccording to claim 76, wherein the American College of Rheumatology-70score (ACR70) of said patient is greater than about 50%.
 79. The methodof claim 51, wherein the disease is primary myelofibrosis (PMF).
 80. Amethod according to claim 79, wherein the method results in a reducedtotal symptom score (TSS) of said patient compared with baseline.
 81. Amethod according to claim 79, wherein said method results in reducedanemia.
 82. The method of claim 51, wherein the disease ispost-polycythemia vera myelofibrosis.
 83. The method of claim 51,wherein the disease is post-essential thrombocythemia myelofibrosis. 84.The method of claim 62, wherein the disease is psoriasis.
 85. A methodaccording to claim 84, wherein the Psoriasis Area and Severity Index-50score (PASI 50) is greater than about 70%.
 86. The method of claim 62,wherein the disease is rheumatoid arthritis.
 87. A method according toclaim 86, wherein the American College of Rheumatology-70 score (ACR70)of said patient is greater than about 40%.
 88. A method according toclaim 86, wherein the American College of Rheumatology-70 score (ACR70)of said patient is greater than about 50%.
 89. The method of claim 62,wherein the disease is primary myelofibrosis (PMF).
 90. A methodaccording to claim 89, wherein the method results in a reduced totalsymptom score (TSS) of said patient compared with baseline.
 91. A methodaccording to claim 89, wherein said method results in reduced anemia.92. The method of claim 62, wherein the disease is post-polycythemiavera myelofibrosis.
 93. The method of claim 62, wherein the disease ispost-essential thrombocythemia myelofibrosis.